Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Felton Surgery on 14 February 2017. 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 for reporting and recording significant events.

• Risks to patients and staff were assessed and well managed.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. They had the skills, knowledge and experience to deliver effective care and treatment.

• The practice used the information collected for the Quality and Outcomes Framework (QOF), to monitor and improve outcomes for patients. The practice’s overall achievement, for 2015/16, was better than the local clinical commissioning group (CCG) and England averages.

• All staff were actively engaged in monitoring and improving quality and patient outcomes. They were committed to supporting patients to live healthier lives through a targeted and proactive approach to health promotion. This included providing advice and support to patients to help them manage their health and wellbeing.

• Staff had been proactive in identifying patients with complex needs and multiple long-term conditions, to help ensure they received appropriate care planning and treatment.

• Services were tailored to meet the needs of individual people and were delivered in a way that provided flexibility, choice and continuity of care.
• Information about services and how to complain was available and easy to understand.

• The practice had satisfactory facilities and was well equipped to treat patients and meet their needs.

• There was a clear leadership structure and staff felt well supported by the management team. The practice had a very effective governance framework, which focussed on delivering safe, good quality care.

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

There was also an area of outstanding practice:

• The practice had been very proactive in taking steps to reduce emergency attendances by patients into hospital, at a time when the local care trust had seen these increase. They had identified a need to reduce emergency attendances and, to help them do this, they had implemented a new appointment system which provided patients with access to same day care. The practice had then audited the improvement they made and this showed that, although the local hospital trust had seen their emergency admissions rate rise by 3.9%, due to winter pressures, the emergency attendances by patients registered with the practice, had reduced by 14% over the same period of time. This included a 20% reduction in emergency attendances by patients aged over 65 years of age, as well as a 50% reduction in emergency attendances by patients aged under five years of age.

However, there were also areas where the provider should make improvements. The provider should:

• Carry out a recorded risk assessment in relation to any decision made not to obtain a Disclosure and Barring Service check for staff appointed to a particular post.

• Continue to review the practice’s carers’ register to make sure it accurately reflects the number of patients who are also carers.

• Display in the patient waiting area information about how to make a complaint.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice