Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr N Nagpal’s Practice on 8 July 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 assessed and managed.
• 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.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they sometimes found it difficult to get through to the practice by telephone but it was possible to make an appointment with a named GP and 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. However, we noted building maintenance issues were not always dealt with in a timely manner and access within the practice was potentially difficult for those with mobility issues due to the internal design of the building.
• 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.

We saw several areas of outstanding practice including:

• A template had been developed and was being used by nursing staff to support patient consultations and provide the opportunity for patients to be more involved in their own care and to gain a greater understanding of how lifestyles affect their health.

• GPs would often work beyond normal appointment times to ensure all patients visiting the practice were seen.

• A GP would visit the homes of deceased patients, often outside of normal practice hours and at weekends, to provide priority support to bereaved families and enable them to act in accordance with religious beliefs.

The areas where the provider should make improvement are:

• Ensure infection prevention and control lead role and responsibilities are documented and understood to enable the effective oversight and scrutiny of associated activity.

• Ensure clinical audit activity is fully documented and supported by a quality improvement programme.

• Prioritise and address building maintenance issues.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice