Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. The previous inspection, carried out on 24 November 2015 rated the practice as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students) – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Ilkley and Wharfedale Medical Practice on 28 February 2018. We carried out this inspection as part of our inspection programme.

At this inspection we found:

• There was an open and transparent approach to safety and clear systems were in place for recognising, reporting and learning from incidents.
• Staff were aware of current evidence based guidance. Staff had received appropriate training to provide them with the necessary skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey were consistently high. We saw that patient satisfaction in relation to access to appointments, and for receiving compassionate care was higher than local and national averages across all areas. We heard that people were respected and valued, empowered as partners in their care, and that a holistic personalised service was routinely provided for patients.
• Patients had access to a named GP. There was continuity of care, with urgent and non-urgent appointments available the same day.
• There was evidence of a cohesive team with a clear leadership structure in the practice. Staff were aware of their roles and responsibilities. Staff told us they felt supported in their roles.
• The practice performed well in relation to cervical, breast and bowel cancer screening. Childhood immunisation uptake stood at 100%.
• The practice regularly reviewed the effectiveness and appropriateness of the care provided.
• We saw evidence that the practice performed consistently better than other practices in the Clinical Commissioning Group area in relation to non-elective hospital admissions and accident and emergency attendances.
• We observed staff treating patients with kindness and compassion. The practice had good facilities and was equipped to treat patients and meet their needs.

The area where the provider should make improvements is:

• Review and improve their responses to complaints so that they always include the details of the Parliamentary and Health Service Ombudsman.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Ilkley and Wharfedale Medical Practice on the 24 November 2015. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed, with the exception of those relating to fire safety checks.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• Patients said they were treated with 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 and general appointments by the next 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.

We saw several areas of outstanding practice including:

• Weekly warfarin drop in clinics run at the practice to ensure local access to services.
• Access to appointments was exceptional with on the day or next day appointments being available to patients as routine. Emergencies were always accommodated on the same day by effective triaging.
• Effective collaboration with the multi disciplinary team (MDT) and community matron and prompt responses to patient need had lowered the A&E admissions rate at the practice.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should

• Ensure all necessary medications and equipment stored for emergency procedures are in place.
• Ensure a monitoring record of clinician’s professional registration is in place.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice