Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Drs Cloak, Choi and Milligan on 21 June 2016. Overall, the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Lessons were learned when incidents and near misses occurred.
• 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.
• 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.
• Extended hours appointments were available from 5:30pm until 7:30pm on a Monday and Wednesday.
• 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 regulation.

We saw two areas of outstanding practice:

• The practice recognised the need for the control and delivery of evidence based medicine. A practice formulary had been developed and implemented, this included appropriate references where required. A system was in place to ensure the formulary was regularly updated. A quick reference guide had also been developed for use during consultations with patients. The work required to complete this formulary, and to ensure it is kept up to date is considerable.
• Data from the National GP Patient Survey, published in January 2016, showed that patients rated the practice highly for their experience of care at the practice. For example, of those that responded 100% patients had trust and confidence in the last GP they saw (CCG average 95%, national average 95%). 95% of those that responded said that the last GP they saw or spoke to was good at treating them with care and concern (CCG average 87%, national average 85%).

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

The information we reviewed showed the practice has a good track record for maintaining patient safety. The GPs looked at how they could continually improve the service and learn lessons from any incidents that had occurred.

The patients we spoke with as well as those who who completed the CQC comment cards were complimentary about the care and treatment being provided. We heard how the practice had responded to patients views and reviewed the appointment system. We saw that there were a wide range of ways to make appointments from in person to on line and advance appointments were available.

Staff were responsive to patients’ needs and has tried to encourage them to share their views and suggestions. The practice ran a virtual patient participation group, which had 102 members and also completed annual surveys of all their patients.

The building is well-maintained and very clean. Effective systems were in place for the oversight and management of medication. Clinical decisions followed best practice recommendations.

We found that the leadership team were very visible. Governance and risk management measures are in place.

The practice safely and effectively provided services for all patient groups. The staff were caring and ensured all treatments being provided followed best practice guidance.

We found that the practice had met the regulations and provided services that were safe, caring, responsive, well-led and effective.