Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Ballater Surgery on 19 January 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand and was available in five non-English local languages relevant to the practice population.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the Patient Participation Group.

We saw several areas of outstanding practice:

• The practice had trained a member of staff to become Patient Liaison Officer (PLO) who assisted in care planning for older patients for example with dementia. The PLO usually contacted the patient after their initial care plan had been set up. Patients were given access to the PLO by phone, to contact if they have any non-clinical queries for example about hospital appointments (booking and chasing), transport and signposted to services available locally. They had shared this initiative with other practices in the Clinical Commissioning Group (CCG) area and had helped train fifteen administrative staff for the PLO role from GP practices across the CCG.

• The practice had access to medical advice for children by the use of e-mail consultations for example the parents could send photos to help identify childhood rashes.

• The practice placed a strong emphasis on supporting carers of patients with long-term conditions. The practice hosted its own carers support group and had also run carers workshops on subjects such as emotional wellbeing.

• The practice ran a memory assessment clinic which was led by the healthcare assistant specifically trained to perform this assessment. This had increased the dementia diagnosis rate in the practice. The practice found that many patients did not want a diagnosis of dementia and the patients with possible/likely diagnosis of dementia were identified and were coded to alert staff of their possible increased needs.

The areas where the provider should make improvement are:

• Ensure there is a supply of hot water in all the areas of the practice including consulting rooms.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We reviewed the information available to us about Ballater Surgery on 12 June 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.