Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Elmswood Surgery on 1 June 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 and near misses, and we saw evidence that learning was applied.

• The practice used proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, education courses for patients with long term conditions such as diabetes and working with the local diabetes specialist nurse to improve the wellbeing of patients.

• There was easy access to appointments for patients with a range of appointments on offer including telephone consultations. The practice had invested in increasing the number of appointment telephone lines reducing, reducing waiting times for patients calling to book appointments or speak to a GP. This was evident from the above average patient satisfaction results from the national survey.

• Feedback from patients about their care was consistently positive. Data from the GP survey was consistently high and this included confidence in care provided by GPs and nurses, where 98% of patients surveyed said they had confidence and trust in the last GP they saw or spoke to, and 100% of patients felt the same about the nurses.

• The practice planned and co-ordinated patient care with the wider multi-disciplinary team to deliver effective and responsive care to keep vulnerable patients safe.
• 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).
• Services were tailored to meet the needs of their patients, particularly vulnerable patients. We saw evidence of good practice in encouraging cervical smears in patients with learning disabilities. Patients were offered a settling in appointment in addition to longer appointments of 40 minutes.
• The practice actively reviewed complaints to see if there were any recurrent themes, and identified issues where learning could be applied to improve patient experiences in the future.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision was documented and reviewed by the management on a regular basis.

• The practice had strong and visible clinical and managerial leadership and governance arrangements, and staff told us that they were well-supported and felt valued by the partners.

We observed some outstanding features in the following area:

The practice used clinical audits to drive improvements in the provision of cervical smear tests in eligible women with learning disabilities registered at the practice. Results showed an increase in uptake from 16% in 2015 to 36% in 2016, with all eligible patients having been reviewed and reasons recorded for exclusions.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice