This practice is rated as ‘Good’ overall.

The key questions at this inspection are rated as:

Are services safe? – Requires improvement

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 Dronfield Medical Practice on 30 October 2018. The inspection was carried out under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

At this inspection we found:

• Patients provided positive feedback about the care they had received, and this was supported by findings from external and internal surveys and patient comment cards.
• The practice opened a ‘pool’ appointment system from 10am each weekday morning so that any patient who had been triaged and needed an appointment, or felt they needed to be seen that day, could attend and see either a GP or the nurse practitioner.
• Pre-booked appointments were allocated for 15 minutes in the morning session, and 12 minutes in the afternoon. This recognised that the practice’s higher numbers of patients aged 65 and over often had more complex needs. It also enabled clinicians to be less pressured by allowing them more time to consult effectively.
• The provider achieved 99.5% in the 2017-18 Quality and Outcomes Framework (QOF), which was in line with the previous year’s total. This was in alignment with local averages and slightly above the national average.
• We found effective systems were in place to promote adult and child safeguarding.
• Immunisation and cancer screening rates were high and exceeded local and national averages.
• The practice team reviewed significant events, including positive ones, to learn and share best practice. If a patient was involved in an adverse incident, they would receive an explanation as part of the duty of candour.
• The monitoring and recording of temperatures in the practice’s vaccine refrigerators were not always being undertaken in line with guidance. The practice took immediate action to address this matter when we brought this to their attention.
• Environmental risk assessments had been undertaken, including fire and Legionella.
• The practice ensured that care and treatment was delivered according to evidence-based guidelines.
• The practice encouraged learning and improvement, and we saw that staff were up to date with the practice’s training schedule. As a training practice, there was an emphasis on continual learning and there were mechanisms in place to support this including weekly clinical meetings, daily clinicians’ ‘huddles’ to discuss any cases of interest and proposed referrals, debrief discussions, and an established clinical audit programme.
• We found an open and supportive culture within the practice. Staff felt valued and told us they found the GPs and the practice manager to be accessible and approachable.
• The practice had established strong links with their community and had engaged in events to support local services and to promote healthy lifestyles to benefit the wider community.

Importantly, the provider must make improvements to the following areas of practice:

• Ensure care and treatment is provided in a safe way to patients. The monitoring of vaccine refrigerators must be maintained in line with guidance, supported by appropriate documentation, with appropriate action taken in the event of any arising concerns.

There were also some areas where the provider should make improvements:

• The infection control lead should attend some additional training to support their ‘lead’ role.
• The practice should consider formal recording of regular oxygen cylinder checks.
• The practice should review their complaints procedure to ensure this accurately reflects guidance.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

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

Letter from the Chief Inspector of General Practice

We inspected this practice on 21 October 2014, as part of our new comprehensive inspection programme. The practice had not previously been inspected. We found the practice to be good in all the key areas we inspected; the overall rating is good.

Our key findings were as follows:

• Patients expressed a high level of satisfaction about the way the services were provided. Patients were asked for their views, and their feedback was acted on to improve the service.
• Robust systems have been put in place to help keep patients safe and to protect them from harm.
• Staff worked well together as a team, and received appropriate support, training and an appraisal to enable them to carry out their work effectively.
• Patients were treated with kindness, dignity and respect.
• The appointment system was flexible and enabled patients to access care and treatment when they needed it.
• There was a commitment to improving the quality of care and services for patients. The governance systems have been strengthened to ensure that the practice is providing high standards of service.  

The provider should:

Ensure that the recruitment policy is followed to provide assurances that new staff are suitable to carry out the work they are employed to undertake.

Provide comment slips and complaint forms to enable people to use the suggestion and comments box.

Ensure that completed appraisal forms detail all aspects of staff performance and learning and development needs.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice