Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at New Court Surgery, Weston Super Mare on 17 February 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing well-led, effective, caring and responsive services. It was also good for providing services for the older people, children and families and young people, the working population, people in vulnerable circumstances and with long term conditions and people with mental health problems.

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 by a skilled clinical team.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance with 7% of the most vulnerable patients being discussed at regular multidisciplinary meetings. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Their care and treatment was provided in a way which protected their privacy.
• Information about services and how to complain was available but not promoted clearly in the waiting areas.
• Patients said they found it easy to make an appointment with a GP and that there was continuity of care, with urgent appointments available the same day.
• The practice had modern, purpose built 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:

• The practice had a clear and overarching view of vulnerable patients with 7% of patients registered with the practice having their needs routinely monitored during multi-disciplinary team meetings.

• The practice had worked with the Clinical Commissioning Group (CCG) to implement a localised ‘Map of Medicine’ system of care pathways to ensure they consistently give the same level of care to patients across the CCG area. (The ‘Map of Medicine’ provides over 400 patient pathways, based on the most up to date research and clinical evidence available).

• Where urgent home visits were required during normal appointment times the practice had a commissioning arrangement with the Out of Hours service for them to carry out the visit. This reduced the risks to patients in urgent need and prevented possible hospital admissions.

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

Importantly, the provider should:

• Review how information is recorded on the significant events log.
• Review how emergency medical equipment is stored and located.
• Review the information available for patients on the practice noticeboards.
• Review how information about the practices vision and values are shared with all staff and patients.
• Review the frequency of fire evacuation testing to ensure the systems in place work as planned.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice