Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Orchard Court Surgery (Drs Charlton, Russell, Stevens & Stone) on 2 March 2015. Overall the practice is rated as outstanding.

Specifically, we found the practice to be outstanding for safe, caring, responsive and for being well led. It was also outstanding for providing services for all the population groups. It was good for providing effective services.

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

• There were comprehensive systems in place to keep people safe, which took account of current best practice. The whole team was engaged in reviewing and improving safety. There was an open culture in which all safety concerns raised by staff and patients who used services were highly valued as integral to learning and improvement.
• The practice was proactive to anticipating and managing risks.
• The team was making use of clinical audit tools, intelligence monitoring tools, appraisals, clinical supervision and staff meetings to assess the performance of the practice and its staff.
• Staff recognised and respected the totality of patients’ needs. They always took account of patients’ personal, cultural, social and religious needs.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the Patient Participation Group (PPG).

• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand.
• Patients could access appointments and services in a way and at a time to suit them.
• The involvement of other organisations and the local community was integral to how services for patients were planned.
• The practice had a clear vision which had quality and safety as its top priority. High standards were promoted and owned by all practice staff with evidence of team working across all roles.
• There was a high level of staff satisfaction. Staff were proud of the practice they worked for and spoke highly of the culture.

The practice demonstrated, across all the population groups, elements of outstanding practice. This related to all the domains, primarily in those of safe, caring, responsive and well led. Some examples are detailed below:

• The practice used every opportunity to learn from internal and external incidents, to support improvement. Information about safety was highly valued and was used to promote learning and improvement. Risk management was comprehensive, well embedded and recognised as the responsibility of all staff.
• The practice actively promoted diabetic patient education schemes and a locally procured CCG scheme and could demonstrate a high uptake from patients when compared to other practices in the CCG.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people, including attendance at multi-disciplinary meetings from the voluntary sector
• The practice had comprehensive systems in place for managing medicines and audits showed this had had a resulting positive outcome for patients.
• We were provided with multiple examples which demonstrated the practice’s commitment to work collaboratively with other partners to improve outcomes for people. Examples included the falls prevention team, Darlington Healthy Hub, and the Darlington rehabilitation stroke unit.

• Staff applied a holistic approach to managing patients. We were provided with multiple examples where staff had supported patients with other aspects of their lives, such as their social life to enhance their health and wellbeing. Staff had sourced activities for patients in their own time and shared this with patients. Patient feedback was aligned to this.
• The practice actively used local and national data to examine their performance and look for areas where they could improve. For example, the practice had carried out a review following a published national asthma deaths report in 2014 and had taken a number of actions in its local context in response to the themes from the national report.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice