This practice is rated as Good overall (Previous rating October 2015 Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Churchgate Surgery (AKA Millgate Health Partnership) on 20 November 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use once they had navigated the telephone system and that they were able to access care when they needed it.
• The practice had a diverse clinical team including paramedics and pharmacists in addition to GPs, advanced nurse practitioner and practice nurses to enable them to respond to the diverse need of patients including older people who require home visits.
• There was a strong focus on continuous learning and improvement at all levels of the organisation. The practice is also commissioned to provide undergraduate placements in General Practice and Primary Care for all non-medical healthcare professionals including nurses, paramedics and Physicians associates.

We saw some outstanding features within the practice:

• Proactive care and treatment is provided for patient’s resident in care homes. GPs provided weekly rounds to each unit within a large complex in addition to regular reactive care provided by the practice. We were provided with numerous examples of the impact of this work on patient’s wellbeing because of the proactive involvement of clinicians and the patient plan manager at the practice. Data provided by the practice also showed a reduction in the number of patients having to go to A&E or call outs from paramedics to the nursing home.

The areas where the provider should make improvements are:

• Continue to monitor patient experience of the telephone system and make improvements where necessary.

Professor Steve Field

CBE FRCP FFPH FRCGPChief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Churchgate Surgery on 12 November 2015. 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 to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed, including those relating to recruitment checks.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• 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 in the main it was easy to make an appointment with a GP; however the telephone system needed to be improved. The practice had responded and was in the process of upgrading the telephone system. The practice was aware improvements were needed to provide patients with better continuity of care.
• Urgent appointments were 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.

We saw areas of outstanding practice including:

• The coordinated approach to the care, treatment and support for patients aged over 75 and the holistic approach to end of life care. We were provided with several examples of positive outcomes as a result of the work with patients over 75.

• The practice provides a free acupuncture for patients. The service was primarily for patient with chronic neck and back pain. Patients were provided with at least six treatments. By providing this free service in house meant patients did not have to travel to hospital. Outcomes included a reduction in the use of medication and patients reported a better quality of life.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice