Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Hadwen Medical Practice on 21 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.
• 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.
• 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 provided the initial health assessments for all children entering local authority care homes and known to Gloucestershire social services agencies. Templates developed by the practice were adopted country wide and led to faster information recording rates. In 2014, the Care Quality Commission noted that the practice had a clear approach and good processes in place to ensure that their vulnerable child databases were kept up-to-date.
• 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.
• When there were unintended or unexpected safety incidents, patients received reasonable support, truthful information, a verbal and written apology and were told about any actions to improve processes to prevent the same thing happening again.

We found one area of outstanding practice:

• The patient participation group (PPG) was well engaged and represented across all age groups, including two 16 year olds and two carers also engaged and providing a contribution. The PPG suggestions for changes to the practice management team had been acted upon and as well as this, the group had raised awareness about patient services. For example, following PPG suggestions, the practice changed the release time of its next day appointments to better suit patient needs, and invested in telephone monitoring software that alerted staff whenever a caller had been waiting for an extended period of time.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We visited Hadwen Surgery on 22 November 2013. We spent time with the registered manager, practice manager, nursing staff, safeguarding lead, reception staff and patients. All of the patients we met spoke positively about the treatment and support they had been given. One person told us “fantastic surgery – doctors are brilliant”.

Patients told us that the clinical staff took time to discuss and explain their care and treatment. All the patients we spoke with told us that staff were professional and knowledgeable about them and their health condition. One person said “they explain everything – everyone is helpful”.

Staff had received training in safeguarding children and were accessing training in safeguarding vulnerable adults. They were aware of the appropriate agencies to refer safeguarding concerns to that ensured patients were protected from risks of abuse.

We found the building to be clean, well-maintained and pleasant. There were systems in place to monitor safety and cleanliness. People with limited mobility could access the building.

The provider had systems in place for monitoring the quality of service provision. There was an established system for regularly obtaining opinions from patients about the standards of the services they received. This meant that on-going improvements could be made by the practice staff. The chair of the Patient Participation Group told us the practice was responsive to patient feedback.