Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection at Crayford Town Surgery on 11 February 2016. 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; however, the system for learning from significant events needed to be more robust.
• Risks to patients were assessed and mostly well managed. Some mandatory training had not been completed by one non-clinical member of staff; however, this training was booked shortly after our inspection. Annual infection control audits had not been conducted since 2013, but the practice conducted a new audit shortly after our inspection.
• 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.

• Nationally published data showed patient outcomes were mostly above or in line with the locality and nationally. Although some audits had been conducted which led to quality improvements, there was no evidence of a continuous cycle of audits.

• The provider was aware of and complied with the requirements of the Duty of Candour.

• Information about services and how to complain was available and easy to understand, and there was an effective system in place for managing complaints.

• The majority of patients told us they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment; however, results from the national GP patient survey showed the practice was rated below average for consultations with GPs.
• Most patients said they found it easy to make an appointment and urgent appointments were available the same day, but continuity of care was not always available and they had experienced continuing difficulties accessing the practice via telephone. The practice had discussed plans to make improvements.
• 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, and they provided positive examples of how staff had been involved in their vision.

The areas where the provider should make improvement are:

• Ensure all staff are up to date with any outstanding training.

• Review the systems in place for learning from significant events, the completion of annual infection control audits and a second cycle is completed on all clinical audits.

• Continually monitor patient feedback regarding consultations with GPs and telephone access and make any necessary improvements to improve patient experience.

• Consider displaying/providing information on the different avenues of support available to carers, and formalise a system for identifying carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice