This practice is rated as Good overall. (Previous inspection July 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 Dr CP Fairlamb and Partners on 17 May 2018 as part of our inspection programme.

At this inspection we found:

• The practice had systems to keep patients safe and safeguarded from abuse.
• 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 they provided. They ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Results from the National GP Survey were mostly local and national scores.
• The practice organised and delivered services to meet patients’ needs. They took account of patient needs and preferences.
• Access to appointments was good. Patients were able to access care and treatment from the practice within an acceptable timescale for their needs.
• There was a focus on continuous learning and improvement at all levels of the organisation. The practice proactively used performance information to drive improvement.

We saw two areas of outstanding practice:

• Staff were actively engaged to monitor and improve quality and outcomes. The practice had carried out a high level of clinical audit for its size. The audits were well written and clinically relevant showing a determination to improve the service to patients and make prescribing safer. There were several two-cycle clinical audits. These included audits regarding: urinary tract infections (UTI); chronic obstructive pulmonary disease (COPD); treatment of vitamin B12 deficiency; and the use of ACE inhibitors (medications used to treat high blood pressure). As a result of these audits templates were designed for clinical staff to improve prescribing and reduce the risk of errors. There were rescue packs compiled with information for patients with chronic conditions such as COPD and management plans for diabetics. The aim of these were to improve their self-care to manage their condition. Protocols were developed and displayed on the walls of every clinical room, such as safeguarding information.
• The practice had a rate of 39% for patients accessing services on-line. The original target was 10%. They had received a letter of congratulations from NHS England who used the practice as a good example for high levels of patients using this facility.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out this comprehensive inspection on 20 July 2015.

Overall, we rated this practice as good. Specifically, we found the practice to be good for providing well-led, effective, caring, safe and responsive services.

Our key findings were as follows:

• The practice provided a good standard of care, led by current best practice guidelines.
• The practice was not able to fully evidence a safe track record over the long term due to not having kept sufficient records. Recent incidents had been reported, recorded and discussed.
• Patients told us they were treated with dignity and respect.
• The practice actively reviewed their performance in the management of long term conditions, and was proactive in offering review and screening services.
• The practice actively sought to make improvements following feedback from patients and patient groups.
• The building had sufficient facilities and equipment to provide safe effective services.

We saw an area of outstanding practice:

• The practice Healthcare Assistant (HCA) had received an award from the County Durham NHS stop smoking service for advice and cessation services offered.

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

The provider should:

• Ensure that stock control and date check systems function correctly so that all single use clinical instruments stored and used are within their expiry dates. Dispose of in accordance with the appropriate guidance any unused instruments or equipment which have expired.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice