Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Fieldhead Surgery on 2 September 2016. Overall the practice is rated as good for providing safe, effective, caring, responsive and well-led care for all of the population groups it serves.

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

• Patients’ needs were assessed and care was planned and delivered following local and national care pathways and National Institute for Health and Care Excellence (NICE) guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Staff were proactive in promoting and offering cancer screening for bowel, breast and cervical and could evidence higher than average uptake rates, compared to CCG and national figures.
• Patients had good access to appointments, which included extended hours early morning, evening and on Saturdays and Sundays. The practice could evidence a low usage of out of hours care as a result.
• 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.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. National GP patient survey results showed patient satisfaction rates for the majority of the questions were higher than both the local CCG and national rates.
• Views were sought on how improvements could be made to the service, through the use of patient surveys, the NHS Friends and Family Test and engagement with patients and their local community.
• Risks to patients were assessed and well managed. The practice had sought input from a specialist health and safety consultancy, which carried out risk assessments and completed all health and safety policies and protocols.
• There were effective safeguarding systems in place to protect patients and staff from abuse. There was evidence of shared learning with a wider team.
• There was a clear leadership structure, staff were aware of their roles and responsibilities and told us the GPs were accessible and supportive.
• There was an open and transparent approach to safety. All staff were encouraged and supported to record any incidents using the electronic reporting system. There was evidence of good investigation, learning and sharing mechanisms in place. The practice was proactive in reporting prescribing and medicines alerts on the local incident reporting system.
• The provider was aware of and complied with the requirements of the duty of candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment.)

We saw an area of outstanding practice:

• The practice provided evidence of how they had effected change in diabetes care pathways for secondary care services, in line with up to date clinical and medicines management guidelines. For example, following input from the practice, insulin prescribing guidelines had been changed and adopted locally for patients discharged from secondary care. This had supported a consistent approach in the management of those patients across both secondary and primary care services within Leeds.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice