Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Dewhurst and Partners on 12 January 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.
• Risks to patients were generally assessed and well managed. However some non clinical staff that were trained to chaperone adults had not had a DBS (Disability and Barring Service) check. This was however in line with their chaperone policy.
• 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.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day. Some bookable appointments were available on the day and up to six months in advance.
• 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.
• The practice took a strong and innovative lead in new initiatives and training in the locality.
• Staff were supported in and encouraged to continue to train beyond their current role.
• The practice were pro-active in taking part in research projects.

We saw some examples of outstanding practice

• The practice had an ethos of training, advancement and nurturing of staff. This had the intended result of increasing the levels of staff satisfaction in their work and improving recruitment and retention of staff.

• The practice was pro-active in proposing, encouraging and carrying out pilot schemes in to the training and use of paramedic practitioners in the locality.

The areas where the provider should make improvement are:

• Ensure that all staff are risk assessed as to whether they require a DBS (Disclosure and Barring Service) check, and record the findings of the assessment.

• Ensure that rehearsals of practice fire safety and evacuation procedures are carried out on a regular basis when the practice is open.

• Consider scanning signed consent forms in to the computer records.

• Investigate the reasons for raised exception reporting for atrial fibrillation, asthma, mental health, rheumatoid arthritis and cervical screening.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

This practice is rated as Good overall. (Previous rating 19 April 2016 – Good)

The key questions at this inspection 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 J Gonzalez & Partners as part of our inspection programme.

At this inspection we found:

• 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 it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• The practice place emphasis on training and support for the whole staff team and staff reported that they felt enabled to develop their skills.
• The practice had developed new and innovative ways of working with information technology to support good patient care.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.