Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Arthur and Partners on 26 October 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 and an effective system in place for reporting and recording significant events. This was shared with all staff who demonstrated a detailed knowledge of learning from previous events.
• Risks to patients were assessed and well managed through good emergency planning strategies and staff training. The practice was proactive in responding to risks outside of the building, such as in the provision of emergency grab bags for road accidents following a number of incidents.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment and this was regularly assessed with a programme of audits.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. A highly active patient participation group encouraged involvement from patients.
• 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 and additional capacity provided by an emergency care practitioner.
• 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.
• The provider was aware of and complied with the requirements of the duty of candour.
• There was significant, seamless provision for patients at the end of their life through a robust palliative care programme. This included multidisciplinary team coordination, home visits, regular meetings and a review of every patient death to ensure every effort was made to ensure patients died in their preferred location. In addition, staff sent a bereavement support letter to carers on the first anniversary of a death with details of how to obtain extra support if needed.

We also saw areas of outstanding practice:

• Staff demonstrated consistent attention to detail and embed and maintain individualised care. This included a home visit to support a patient to use the online booking system and matching appointment times to the local bus timetable for patients who relied on it for transport.
• The practice proactively engaged with the local community to provide additional services and opportunities for patients. This included devising an introductory programme to primary care for students applying to university and opportunistic health checks offered in a local supermarket. The patient information group had successfully organised a health and wellbeing event that attracted 25 local services or organisations to help improve health promotion and reduce social isolation, which received praise from the town’s mayor.
• The practice worked with the clinical commissioning group and community service providers to support homeless and refugee patients. This included providing staff with specialist safeguarding training and updating patient protection policies.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice