Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Young & Partners

on 10 November 2016. Overall the practice is rated as outstanding.

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

• There was an open and transparent approach to safety within the practice. Effective systems were in place to report, record and learn from significant events. Learning was shared with staff and external stakeholders where appropriate.
• The additional post of a safety lead had led to quarterly governance meetings and a full review of procedures to reduce risks and instil an ethos of safety and continuous development in this area with staff.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Outcomes for patients were generally above or in line with local and national averages.
• Training was provided for staff which equipped them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion and dignity, and staff were supportive and respectful in providing care, involving them in care and decisions about their treatment.
• Patients told us they were able to get an appointment with a GP when they needed one, with urgent appointments available on the same day.
• The practice had been ranked second in Derby city and 16th in the county in feedback from the GP patient survey, results showed that patients rated the practice highly. All questions were rated above the local and national average, For example 92% of patients stated they would recommend this surgery to someone new in the area, against a local average of 80% and a national average of 78%.
• 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 and learning from complaints was shared with staff and stakeholders.
• The practice had good facilities and was well equipped to treat patients and meet their needs. Services were designed to meet the needs of patients.
• 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.

We saw areas of outstanding practice:

• Staff had highlighted a potential weakness in the local safeguarding system and had taken it upon themselves to further enhance the safeguarding system to ensure safeguarded patients were proactively managed and potential risk was anticipated and treated appropriately. This was recognised as the responsibility of all staff and we saw several examples where a team approach had been taken to work with community staff to maintain an effective approach to safeguarding. This included having failsafe systems to ensure children and vulnerable adults at risk of harm were not missed.
• Bespoke ‘pop-up’ warnings were set up on the computer system for high risk medicines for example ACE inhibitors and warfarin. These alerted clinicians to the latest guidance and areas to discuss with patients in terms of assessing risk of the medicines side effects versus benefits. This was part of a drive to reduce reliance on clinicians’ memory of updates and ensure patient safety. This had derived from a review of an external significant event and the practice staff had implemented the learning outcomes to reduce the likelihood of prescribing error happening again.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice