We carried out an announced comprehensive at Meneage Street Surgery on 20 February 2019 as part of our inspection programme.

This practice is rated as Good overall. (Previous rating September 2015 – Good)

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

At this inspection we found:

• The practice had recently had major partnership changes due to retirement and ill health but continued with effective succession planning.
• Leaders were knowledgeable about issues and priorities relating to the quality and future of services and participated in external groups to ensure they understood the local changes and challenges.
• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice recognised where systems and processes had worked well and improved their processes where appropriate.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Medicines and high risk medicines were managed well.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning, improvement and involvement at all levels of the organisation.
• Staff said the leadership team were supportive and approachable and added that the practice was a good place to work.
• The staff worked effectively with other practices in the area and took part in the Improving patient access programme.

We saw three areas of Outstanding practice:

• The practice had employed a prescribing practice matron in the last 18 months. It had been estimated that the role had saved 200 GP hours in the last quarter and contributed to continued low hospital admissions, increased identification of carers and higher than local and national averages of dementia Quality and Outcome Framework scores.
• The practice manager had developed, maintained and monitored many systems, spreadsheets and tools for the effective running of the practice and safety of patients. These included systems to monitor referrals; appointment availability and take up; workflows; safety alerts; medicine and long-term condition recalls; pathology results; patient deaths; hospital admissions; and non- clinical requests.
• The practice had identified a trend to move secondary care services into the community and as a result had extended the property to provide a surgical unit and subsequent twice weekly macular surgical service. The service was managed by the practice and had resulted in reduced hospital staffing, expenditure, operating costs and increased clinical capacity for the hospital.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Meneage Street Surgery on 15 September 2015.

Overall the practice is rated as good.

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

• Staff fulfilled their responsibilities to raise concerns and report incidents. All opportunities for learning from incidents were maximised.

• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice.

• Patients said they were treated with compassion, dignity and respect and were involved in decisions about their treatment. Information was provided to help patients understand the care available to them.

• The practice worked closely with other organisations in planning how services were provided to ensure that they meet people’s needs.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the Patient Participation Group (PPG).
• The practice was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand

• The practice had a clear vision which had quality and safety as its top priority. A business plan was in place, that was monitored and regularly reviewed and discussed with all staff. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice