Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Menston and Guiseley Practice on 1 March 2016. Overall the practice is rated as good for providing safe, effective, caring, responsive and well-led care for all of the population groups it serves.

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 with a named GP 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.
• Patients were positive about access to the service. They said they found it easy to make an appointment, there was continuity of care and urgent appointments were available on the same day as requested.
• Longer appointments were given to those patients requiring interpreter services. A small number of identified patients with complex needs were fast tracked for access to a clinician.
• The practice sought patient views how improvements could be made to the service, through the use of patient surveys, the NHS Friends and Family Test and the patient participation group.
• The ethos of the practice was to deliver good patient centred care.

We saw several areas of outstanding practice including:

• A diabetes pre-screening programme was initiated and run by the practice. This had identified additional patients in need of diabetic care and provided a programme of support.

• The practice worked in partnership with patient empowerment project (PEP) initiated by Leeds West Clinical Commissioning Group CCG. This was to provide a link to services in the community which can provide support to the patients for instance with mental health, visually impaired and local based support groups.

• Following the closure of contraception and sexual health (CASH) service locally and feedback from patients, the practice has improved its provision of sexual health services and employed additional trained female clinical staff to manage contraceptive services.
• The practice proactively developed a‘Hub’ relationship with three other local practices which allowed greater flexibility and access for patients to book appointments with a GP or a nurse. This gave patients seven day access to both GPs and nurses, reducing admissions to accident and emergency and stresses on the appointments overall at the practice.

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

Importantly the provider should

• Review emergency medicine and equipment audits to ensure that risks are minimised.

• Review the provision of training for HCAs to ensure they are confident, competent and safe when administering vaccine.

• Review infection control monitoring and ensure key staff have training to be effective in that role.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice