Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at London Road Surgery and the branch site of Elstow Medical Centre on 23 February 2016.

Throughout our report, when we refer to ‘the practice’, we are including both sites, unless specifically mentioned by name. Overall the practice is rated as good.

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

• The practice had a clear vision, had recognised the needs of patients in the community it served and set out to deliver services to meet the needs of its patients.

• The partners had worked constructively to create an open and transparent approach to safety. A clear system, which was made known to all staff, was in place for reporting and recording significant events.

• Risks to patients were identified, assessed and appropriately managed. For example, the practice implemented comprehensive recruitment checks for new staff, undertook regular clinical reviews and followed up-to-date medicines management protocols.

• We saw that the staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff were encouraged and supported to access relevant training, to ensure they had the skills, knowledge and experience to deliver effective care and treatment.

• Feedback from patients was generally positive. Patients we spoke with told us they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Comments from patients on the 20 completed CQC comment cards confirmed these views.

• Results from the GP Patient Survey published in January 2016 were generally positive, with most outcomes comparable with local and national averages. For example, 74% of patients would recommend the practice to someone new to the area, which was in line with the local CCG and national average of 79%.

• The practice provided clear and comprehensive information to patients about the services available. Leaflets with advice about how to complain or provide feedback were available to patients in the waiting area and published on the practice website. Where appropriate improvements were made to the quality of care as a result of complaints and concerns. Outcomes from complaints were shared and learning opportunities identified as appropriate.
• Appointments were readily available. Urgent appointments were available the same day, although not always with the patients named or usual GP. Ninety percent of patients said the last appointment they got was convenient, which was comparable to both local and the national average of 92%.
• Services were provided from two sites across Bedford, patients could attend at either location. Both sites occupied purpose built premises which had access to good facilities and equipment in order to treat patients and meet their needs.

• There was a clear leadership structure and we noted there was positive outlook among the staff, with good levels of morale in the practice. Staff said they felt supported by management.

• The practice proactively sought feedback from staff and patients in a variety of ways, which it acted on.
• An externally funded project had facilitated the provision of a ‘Community Health Champion’. The project was identified as a ‘social prescribing’ initiative, designed to improve access to services for people who may face health inequalities.

• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvements are:

• The practice should review issues concerning patient confidentiality at reception and consider what further action may be available to protect patient sensitive and personal information.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice