Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Headley Drive Surgery on 11 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.
• 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 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 two areas of outstanding practice:

• The practice had on screen alerts set up for prescribing broad spectrum antibiotics; this made the prescriber aware that they can only prescribe medicines in the formulary and they must record their justification for prescribing these medicines which was linked to the patients’ notes. For example the practice had an automated template for acute tonsillitis which made clinicians complete a centor score (predicts the likelihood of bacterial infection) to justify use of antibiotics. Following the implementation of this system monthly antibiotic prescribing audits showed a decrease in prescribing rates from 772 to 573 in a four month period. The practice looked at the antibiotic prescribing of individual GPs as part of this monthly audit.
• The practice offered frontline telephone clinic between 9:00am and 1:00pm everyday where patients could speak to a GP who provided telephone advice or offered face to face appointments where appropriate. On average GPs were able to deal with 35 patients each day compared to 17 face to face appointments in a traditional setting. Following the implementation of this clinic the practice’s DNA rate (number of patients who did not attend their appointment) had reduced by 5%.

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

• Review practice procedures to ensure that there is a system in place for monitoring the use of blank prescriptions.
• Review systems in place to ensure that patients with a learning disability are regularly reviewed.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Headley Drive Surgery is owned by AT Medics and provides personal medical services for approximately 2.500 people. It is an accredited training practice and employs two part time doctors, a practice manager, a practice nurse, a healthcare assistant and administrative and reception staff. During our inspection visit we were able to speak with one of the General Practioners, (GP’s) who is also the registered manager, the practice manager, practice nurse and two members of the administration team.

We were also able to speak with three patients who had attended the surgery that day. They said that they were very happy with the practice. They told us that they did not experience any problems making appointments; they found the staff “very helpful” and “very friendly”. People told us that they felt involved in discussions about their health care and that the doctors always had time to listen to them. One person told us “I wouldn’t go anywhere else, the doctors here are wonderful”. One person did suggest that the practice would benefit from having a paediatric doctor. The GP agreed that the practice population included a lot of children and they were looking at ways to improve access to paediatric specialists.

We looked at the results both from the patient surveys undertaken by the practice and the 2012-13 GP practice survey run on behalf of NHS England. These indicated that the majority of patients who had taken part were satisfied with the practice and 62% would definitely or probably recommend the practice to people they knew.