We carried out an announced comprehensive inspection at Cotswold Medical Practice on 2 September 2016. Overall the practice is rated as good, and outstanding for providing responsive services.

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 practice had good facilities and was well equipped to treat patients and meet their needs.
• 97% of patients said they could get through easily to the practice by phone compared with the clinical commissioning group (CCG) average of 83% and the national average of 73%.
• The patient participation group (PPG) were well engaged and represented across all age groups, and across a diverse range of professional backgrounds. The PPG suggestions for changes to the practice management team had been acted upon. Also the group had raised awareness about patient services. The practice is participating in a social prescribing scheme to support people who attend their GP surgery but do not necessarily require medical care. Social prescribing supports people with issues such as social isolation and coping with caring responsibilities, to connect to services and groups that can help improve their wellbeing and meet their wider needs.
• Staff had lead roles that improved outcomes for patients such as a care co-ordinator and a carer’s champion.
• 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.
• When there were unintended or unexpected safety incidents, patients received reasonable support, truthful information, a verbal and written apology and were told about any actions to improve processes to prevent the same thing happening again.

We saw three areas of outstanding practice:

• The practice funds and hosts a memory clinic. Following in-house assessments, patients may be referred to clinicians who specialise in memory problems, such as psychologists, geriatricians or dementia specialist nurses. The clinic has been running for four years, with a total of 67 patients referred in the past 12 months.
• The practice rents a room in a local organisation for art therapy sessions. The service is funded by charitable donations raised by the practice and available on referral, for patients who have suffered bereavement, were carers, or were experiencing mental health issues. An average of 25 practice patients per week attend classes and a total of 33 patients have attended classes this year.
• The practice hosts a skin camouflage service for patients who would like to camouflage scarring or a skin condition such as vitiligo. The service is provided by a charity, which is supported by donations from the practice, and is available on referral. The practice has referred 15 of its patients in the past four years, and hosts this service for the county and wider area.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice.