Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Glebe Road Surgery on 2 August 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.
• Overall, risks to patients were assessed and well managed; however, the practice did not have an up to date fire risk assessment.
• The practice was clean and tidy. The practice informally monitored the performance of the cleaner, who was employed via an external company; however, there was no cleaning schedule or record of cleaning carried-out.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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 found it easy to make an appointment with a named GP and 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.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision was regularly reviewed and discussed with staff.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.
• 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.

We saw two areas of outstanding practice:

The practice provided joint consultations with psychiatrists in order to provide an enhanced level of care to patients with mental health needs, whose conditions were difficult to manage, but were not sufficiently severe to meet the criteria for hospital referral; they had provided this service to seven patients since 2012, and on average had provided approximately three appointments of this kind per patient. Where appropriate, these appointments had been provided in the patient’s home. In each case a tailored care plan had been developed for the management of the patient’s condition.

The practice showed a strong commitment to contributing to the future of general practice and was a learning hub for a broad spectrum of roles, both clinical and non-clincial. This involved providing training placements for medical students, foundation year doctors (including “trainees in difficulty”), GP registrars, and for student nurses. They also provided training opportunities to allied health professionals such as physiotherapists and paramedics, and to specialist doctors such as dermatology registrars. The practice had also participated in the pilot scheme for training physician associates. In addition to training clinical staff, the practice also provided work experience placements for school students and apprenticeship placements. The practice produced its own resources to support its trainees, such as personal induction booklets and tailored work books.

The areas where the provider should make improvement are:

• They should ensure that their business continuity plan is reviewed and updated.
• They should update their fire risk assessment and risk mitigation plan.
• They should put in place a cleaning schedule, outlining the cleaning tasks required, and ensure that a record is made of the cleaning completed.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice