Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at

Dr Winter-Barker, Roberts, Stonehouse, O’Sullivan and Mr Eddy

on 16 November 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 report incidents and near misses.

• All staff were actively engaged in activities to monitor and improve quality and outcomes for patients.

• Risks to patients and staff 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 responsibilities.

• The practice had satisfactory facilities and was equipped to treat patients and meet their needs at both sites. Plans had been made to improve access arrangements at the main practice site.

• Staff were consistent and proactive in supporting patients to live healthier lives through a targeted approach to health promotion. Information was provided to patients to help them understand the care and treatment available to them.

• There was a clear leadership structure and staff felt supported by the management team. Good governance arrangements were in place.

• Staff had a clear vision for the development of the practice and were committed to providing their patients with good quality care.

• Feedback from patients was positive about the way staff treated them. Patients said they were treated with compassion, dignity and respect. Arrangements had been made which promoted and supported patients to become active partners in their care. However, the arrangements for preventing unauthorised access to patient related information could be improved.

• Information about how to complain was available and easy to understand.

  W

  e also saw areas of outstanding practice:

• The NHS GP Patient Survey results showed

  the practice had performed very well in all areas

  , especially in relation to patient satisfaction with the quality of GP and nurse consultations, staff’s commitment to providing patients with good continuity of care and access to appointments.

• Following feedback from the local NHS Trust, the practice improved how it delivered services to patients with dermatological conditions. In 2014, a GP partner completed a diploma in Dermatology. They saw the practice’s own patients who had dermatological needs as well as patients from other practices. There was evidence that this had had a very positive impact on the way in which the needs of these patients were managed. For example, the referral rate to secondary specialist services had reduced from 198 patients, in 2014, to 80 for the same period in 2015, which meant more patients benefitted from receiving care and treatment closer to home.

• A named GP provided a fortnightly ‘ward round’ at a local care home for patients with complex healthcare needs. This helped to pre-empt any potential health problems. These patients were also able to access same-day urgent care, from the same GP.

• The practice participated in the ‘Unplanned Admissions’ enhanced service and had identified 2% of patients who were at greater risk of hospitalisation. Arrangements had been made to carry out reviews of the needs of these patients and provide feedback to the clinical team each month. Staff also reviewed the needs of patients who had been admitted into hospital to identify whether this could have been prevented. Recent local Clinical Commissioning Group data showed that unplanned admissions into hospital had reduced by 12.7% and that the practice had the second lowest level of unplanned admissions for the most recent month.

In addition, the provider should:

• Consider using a second thermometer to check the accuracy of the temperature readings displayed on the thermometer installed in the dispensary refrigerator. The provider should also arrange for annual calibration checks to be carried out of the thermometer installed in the dispensary refrigerator.

• Provide the member of staff designated as the practice’s infection control lead with advanced infection control training.

• Make sure that patient related information is kept secure at all times and can only be accessed by authorised persons.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice