Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Central Surgery on 2 October 2017. 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 a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.

• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with said they found urgent appointments available the same day however they found it was not easy to make an appointment with a named GP and there was limited continuity of care.
• 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 patients, which it acted on.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

However, we saw areas where the provider should make improvement:

• Ensure that standard operating procedures are fit for purpose, regularly reviewed, and have been signed by all dispensary staff.
• Review the checking procedure for emergency medicines and equipment, and carry out a risk assessment for medicines which are not stocked.
• Review the remote collection service to ensure safety and quality.
• Ensure appropriate infection prevention and control training is provided for the lead nurse.
• Review the system that identifies patients who are also carers to help ensure that all patients on the practice list who are carers are offered relevant support if appropriate.
• Monitor patient access to the practice by telephone to identify if meeting patient needs.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out this comprehensive inspection on 18 February 2015.

Overall, we rated this practice as good.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
• The practice provided a good standard of care, led by current best practice guidelines.
• The practice was able to evidence low rates of emergency admissions to A&E, and low use of out of hours services.
• Patients told us they were treated with dignity and respect.
• The practice had good facilities and was well equipped to treat patients and meet their needs. The risk of infection was kept to a minimum by systems such as the use of disposable sterile instruments.
• The practice had appropriate systems of clinical audit and could evidence learning from these.
• The practice proactively sought to register carers to ensure they were offered sufficient support.

However, there were also areas of practice where the provider needs to make improvements.

The areas where the provider must make improvements are:

• Ensure there are systems in place to safely manage the dispensing of medicines in accordance with relevant legislation.

In addition, the provider should:

• Ensure action and learning points from significant events are documented, to ensure that learning opportunities are not missed.
• Ensure all necessary risk assessments are documented, such as risks to patients using the building, or for lone working.
• Ensure all staff are brought up to date with their appraisals.
• Provide all necessary staff with training around the Mental Capacity Act.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During the inspection we visited the main practice in Barton upon Humber and a branch of the practice at Goxhill, both of which hold surgeries each day Monday to Friday.

Patients spoken with told us staff asked their permission before treatment or examinations or were carried out. Consent forms were completed for invasive procedures such as minor surgery. Comments included, “Doctors always ask for consent and give good explanations of treatment.”

Patients told us they were happy with the care and treatment they received but some had on-going issues with accessing an appointment. Comments included, “I am happy here, I think they do a good job” and “It’s not easy to get an appointment and you can’t book in advance.”

We found the practice to be clean and tidy. There were systems in place to prevent and control the spread of infection. Patients told us staff wore gloves when required and said, “The building is smashing and very clean.”

We found the practice managed medicines well, which ensured patients were dispensed their medicines safely and as prescribed.

We found staff had access to training and were supported in their roles by GPs, nurses and the practice manager. Comments from staff included, “The team leader is always there for me and the practice manager and doctors always support me” and “The practice is very good about planning training and supporting staff.”

We found there were systems in place to monitor the quality of the service provided to patients. This included audits and surveys to obtain patient’s views so that improvements could be made.