Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Francis Grove Surgery on 19 November 2015. 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.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• The practice worked to improve patient outcomes, including with other local providers to share best practice. For example, the practice nurses recruited patients for research studies and actively took part in carrying out research.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• 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.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet people’s needs. For example, with local dementia services.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.
• 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.

We saw several areas of outstanding practice including:

• As well as providing the anticoagulation clinic in-house, the practice nurses undertook home visits to provide this service to their known housebound patients, allowing for continuity of care. The practice

  had gathered patient satisfaction information for the

  anticoagulation service annually to ensure it was continuing to meet patients’ needs. We were shown evidence of surveys for the last two years.

• The majority of the practice population were of working-age. The practice had implemented a well-women’s drop in service once weekly for cervical screening, chlamydia screening, family planning advice and immunisations for pregnant women. This had been running for four years. Following feedback gathered from patients using the drop in service, the practice offered more extended hours sessions for those of working-age with the practice nursing team, to improve access to these services. Patients were very positive about this service that was offered by the practice.
• The practice promoted a local dementia hub and had close links with this service. The practice nursing team organised a dementia open day in May 2015 during Alzheimer’s awareness week, specifically for dementia sufferers and carers. The Patient Participation Group (PPG) also assisted with arrangements for a Saturday flu drop in clinic in September 2015, where representatives from the dementia hub and older people’s services were invited to provide information and support to patients and carers.

However there were areas of practice where the provider should make improvements:

• Ensure that all clinical staff are trained to the required level for safeguarding children.

• Ensure that the reasons for changes made to practice systems are clearly communicated to all staff and ensure that non-clinical staff are given enough time in staff meetings to provide suggestions and feedback.

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