Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bradley Stoke Surgery on 1 June 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The appointment system was kept under constant review and the practice were very responsive to changing the work pattern of the clinical team to meet demand. This meant access for patients was flexible to need and the practice had a rota which changed weekly according to resources and predicted demand such as additional work from clinics.
• The practice had good facilities and was well equipped to treat patients and meet their needs. They had recently completed an extension to the building to provide additional consultation rooms and also to meet demand from a growing practice population.

• The practice registered homeless people and those with an accommodation address, and set up text messaging with them as a preferred communication so as to ensure these patients received relevant information in a timely manner.

• 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.

We saw an area of outstanding practice:

• The practice had several patients who were victims of people traffickers. They nominated clinical staff to meet with health professionals who ran an established health assessment service for asylum seekers and refugees in order to gain additional insight into the complex health issues patients may present with at the practice. They had improved the safety of the service for these vulnerable patients, and established processes to share information and expertise.

The areas where the provider should make improvement are:

• The practice should record emergency equipment checks for all the equipment designated for this purpose to ensure it is still within its ‘use by’ date.

• The practice should formalise their clinical cleaning schedules and include equipment not in daily use.

• The practice should implement their legionella protocol.

• The practice should ensure the recruitment procedure is applied to all posts.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We were welcomed by patients and all members of staff when we visited. The inspection was announced to the service 48 hours prior to our visit. We were supported throughout the day by the practice manager and assistant practice manager. The practice manager had considered a programme for our visit so that we had a variety of patients and staff to speak with. We attended a baby clinic, a treatment room nurse consultation and a clinic for a diabetic review.

We looked at some written comments that patients had left on the NHS Choices website. Comments included “I have a good feeling about the surgery, pleasingly I see my experience is improving with time”, "I was surprised to see negative comments about the surgery. I have been a patient since 1994 and have always received excellent treatment” and “I would recommend this surgery to anyone for the professionalism, dedication and friendliness of staff”.

Staff were happy to share their experiences about how they supported patients who used the service. It was evident staff we met with were “proud” to work at the surgery and the services they provided. Staff supported the surgery and its commitment to deliver quality services in a manner that improved patient experience, their health and wellbeing. The surgery considered the community they were supporting and were always thinking of innovative ways to improve and expand services for patients so that they had access to new care and treatment within their local community.