Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at James Street Group Practice on 19 May 2016. 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.
• Risks to patients were assessed and well managed.
• The practice carried out clinical audit activity and were able to demonstrate improvements to patient care as a result of this.
• Feedback from patients about their care was positive. Patients reported that they were treated with compassion, dignity and respect.
• National GP Patient Survey results in relation to appointment availability and experience and ease of making an appointment were lower than local and national averages. The practice was aware of patient dissatisfaction in this area and were committed to improvement.
• Urgent appointments were usually available on the day they were requested. When this was not possible patients were able to access same day pre bookable appointments at the local primary care access centre.
• The practice had a number of policies and procedures to govern activity, which were reviewed and updated regularly.
• The practice did not have a patient participation group (PPG) but a town wide patient participation group was in operation. PPG members had been involved in canvassing patient opinion, delivering leaflets and advertising the function of the access centre.
• The practice used the Quality and Outcomes Framework (QOF) as one method of monitoring effectiveness and had achieved 97.7% of the point’s available (local clinical commissioning group average 96.8% and national average 94.7%)
• Information about services and how to complain was available and easy to understand.
• The practice had a clear vision in which quality and improvement was prioritised. The strategy to deliver this vision was regularly discussed and reviewed with staff and stakeholders.
• Practice staff were aware of, and complied with Duty of Candour requirements.

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

The provider should:

• Strengthen the arrangements currently in place for checking the expiry dates of emergency medicines and equipment.
• Store all controlled drugs in accordance with relevant legislation.
• Consider adding the discussion/implementation of NICE guidelines as a standard agenda item to clinical meetings.
• Review the arrangements in place for bringing the availability of the chaperoning service to the attention of their patients
• Continue with their plan for all clinical staff to receive training in the requirements of, and their responsibilities in relation to, the Mental Capacity Act
• Consider writing a more formal business plan
• Review their meeting schedule so that all staff are given the opportunity to attend practice meetings

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We were able to speak with seven patients who were in the waiting room when we visited. All of the patients confirmed that the doctor and the staff always explained what they were going to do and were happy with the service they received. However there was a recurrent theme in patient’s responses with regards to them being able to make an appointment. We did not see any circumstances where confidentially was not maintained. Most of the patients we spoke with confirmed that they felt confident that the doctor understood their condition. One patient told us, “The process for referral to secondary care is good and effective.” One of the GP’s told us, “It is the best practice I have ever worked in”.

We found that the practice was clean and tidy. There were adequate disabled facilities and all treatment/consulting rooms were on the same level. All rooms were designed to maintain a patient's dignity and privacy whilst being treated. We saw that staff had received appraisals annually which demonstrated that the competence of staff were assessed and discussed. Members of staff we spoke with told us that there was protected training time and confirmed they had received updated training. The practice participated in the Quality and Outcomes Framework (QOF) system used to monitor the quality of services in GP practices.

We reviewed the information available to us about James Street Group Practice on 14 May 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.