Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr M P Boulton and Dr S K Baddam’s practice on 11 August 2015. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• The majority of risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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.
• 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.

There were areas of outstanding practice.

• A clinic was held in the practice twice a week for those with substance or alcohol misuse related health problems in response to local patient needs. These were conducted by a GP, who had received specialist training, in conjunction with advisors from the local treatment service, Lifeline.
• Two of the GPs had undertaken specialist training in diabetes so they could initiate all types of injectable therapies for diabetes and provide all diabetes care reducing the need to refer patients to secondary care services.
• The practice had developed a template to record the assessment of patients over 75 years which included a social assessment as well as a review of their health needs. The assessment was conducted as part of their annual review. The practice was also engaged with a local CCG initiative reviewing patients over 70 who were prescribed more than three medicines. The reviews included compliance with medicines, social history and falls history.

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

Importantly the provider should improve the following areas:

• There was a process to share medical alerts with staff however there was no record of action taken in response to the alerts.
• A written Legionella risk assessment had not been completed to evidence that all risks had been taken into account and all appropriate action was being taken to minimise risk.
• Records of verbal staff references and records of risk assessements relating to DBS checks had not always been completed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice