Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of College Surgery Partnership on 12 August 2015. Overall, we rated the practice as outstanding. Specifically, we found the practice to be good for providing caring, safe services and effective services and outstanding for providing, responsive and well led services.

We also found the practice outstanding for providing services to older people and good for people with long term conditions, poor mental health including people living with dementia, working age people (including those recently retired and students) and families, children and young people and people whose circumstances make them vulnerable.

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.

• There were arrangements in place to respond to the protection of children and vulnerable adults and to respond to any significant events affecting patients’ well-being.

• The practice worked well with other health care services to enable a multi-disciplinary approach in meeting the health care needs of patients receiving a service from the practice.

• The practice managed complaints well and took them seriously. Information about how to complain was available and easy to understand.

• There was a clear management structure with approachable leadership. Staff were supported and had opportunities for developing their skills, were well supported and had good training opportunities.

• The practice had modern central facilities designed with patients and staff for future population growth.

• The practice had a vision and informal set of values which were understood by staff. There were clear clinical governance systems.

We saw several areas of outstanding practice including:

• The practice had increased the flexibility of access to appointments and could demonstrate the impact of positive patient survey results. The practice offered a same day service (SDS) for patients who had more urgent problems; this was facilitated by two GPs. The practice also offered appointments outside of core hours on four days per week.

• The practice had reached out to the local community by supporting people who were vulnerable by facilitating a walking group, vegetable growing at the practice and ‘knit and natter’ a social group held at the café on site, this increased wellbeing amongst patients who said they really enjoyed taking part.

• The practice has an extremely engaged and active patient participation group (PPG) with over 200 members participating remotely, as well as regular face to face engagement. We saw examples of the PPG being able to influence practice behaviour to benefit patients, for example by continually campaigning to keep the branch surgeries open. They also organised health promotion events.

• The practice was fully committed to working in partnership with the other stakeholders and has recently been part of a two year research project led by the University of Westminster with the aim of improving the health outcomes for those patients with Type 2 Diabetes and those at risk of developing Diabetes. The project, led by the health facilitator, showed clear evidence of health gains for diabetics with reduced HbA1c (a blood test which showed lowered blood sugar levels) reduced weight and waist measurements. This was undertaken over nine months and involved 124 patients. This evidence has led NHS England to sponsor the health facilitator for more work in this area.

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

Importantly the provider should:

• Formally record Hepatitis B status within the personal files of staff.
• Ensure cleaning schedules are signed and dated as tasks are completed, so that equipment is known to be ready for use.
• Ensure robust systems are in place to ensure communications are promptly seen by the GP.
• Review procedures for blank prescription forms kept at branch surgeries.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice