Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hartland Way Surgery on 17 May 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.
• 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 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 one area of outstanding practice

• The practice had an in-house pharmacist who was trained as a clinical associate; they ran regular medicines review clinics for patients with long term conditions and also reviewed medicines for patients who had unplanned admissions to ensure safe prescribing. We saw evidence of many cases where the pharmacist had challenged the prescription of medicines from secondary care and had changed them as a result. We also saw evidence that the prescribing of medicines in general was below average when compared to other practices in the local Clinical Commissioning Group (CCG) for example their prescription of antibiotics was below average.

There were areas of practice where the provider should make improvements:

• Review arrangements in place for monitoring of refrigerator temperatures to ensure staff take appropriate action when temperature is outside of the accepted range.
• Review arrangements in place to ensure that carers are identified so they can be given the support they need.
• Review arrangements in place to ensure that all staff have all mandatory training including basic life support.
• Review the complaints procedure to ensure it contains all the relevant information for patients.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

During the inspection we spoke with seven patients who use Hartland Way Surgery. We spoke with the three partners at the practice which included two GPs and a pharmacist who worked as a clinical associate. We also met with the practice manager, a medical student and four administrative staff.

All of the patients we spoke with were positive about the practice and the care and treatment that they received. They told us, “They look after me very well”, “All the doctors are very good here”, “I’m very happy here, the receptionists are lovely, they greet you by your name.”

We saw that staff were polite and attentive when people arrived at the practice and when arranging appointments with people over the telephone.

Records we looked at showed that people who used the practice were involved in any decisions regarding their treatment.

All areas of the practice appeared clean, tidy and hygienic and there were effective systems in place to prevent and control infection.

We found that staff were supported and received appropriate training to help them deliver care to people accessing the practice. We met with a medical student who told us they’d had a “fantastic experience at this GP.” The people we met described the doctors as “excellent” “very good, he always explains the treatment” and “experienced and capable.”

Effective quality monitoring systems were in place at the practice. There were opportunities for patients and staff to express their views on the quality of the service provided and these were acted on.