Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hartland Surgery on 21 January 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.
• 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.
• 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.
• There was a clear leadership structure and staff felt supported by management. The practice 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 worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. For example, with midwifery services, police services and depression and anxiety services.

We saw three areas of outstanding practice:

• The depression and anxiety service offered appointments at the practice every Friday. Patients benefitted from this service through reduced stress and familiarity with local surroundings. Patients would otherwise have to travel to Barnstaple, 25 miles away, for this. The practice told us they had received excellent feedback from patients about this service.

• The practice offered blood tests for children by one of the GPs. This helped families avoid unnecessary anxiety in children attending hospital, and avoid a lengthy journey to the district hospital 25 miles away for phlebotomy.

• The practice worked closely with a named police community support officer to identify and reach out to people in vulnerable or isolated circumstances to coordinate and offer support services.

The areas where the provider should make improvement are:

• Review the recording system to identify unused prescription pads stored in the safe for auditing purposes.
• Review medicines fridge security to prevent it from being inadvertently switched off.
• Review how siblings and other family members are highlighted on the practice computer system in relation to any child on the at risk register.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

This practice is rated as Good overall. (Previous rating in January 2016– Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Hartland Surgery on 25 September 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• Feedback from patients was positive about the service received.

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

Please refer to the detailed report and the evidence tables for further information.