Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at New Lyminge Surgery on 21 June 2016. Overall the practice is rated as good.

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 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 been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Data from the Quality and Outcomes Framework showed patient outcomes were similar to local and national averages (QOF - is a system intended to improve the quality of general practice and reward good practice).
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Urgent appointments were available the same day. However, some patients told us they had difficulties in accessing routine appointments.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Staff told us that translation services were available for patients who did not have English as a first language and there was a translation facility on the practice’s website.
• There was a clear leadership structure. The practice sought feedback from staff and patients, which it acted on. Staff we spoke with told us they felt supported by management.
• The patient participation group (PPG) was active and representatives told us on the day of the inspection that they were able to suggest changes which the practice actioned when possible.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw several areas of outstanding practice:

• The care co-ordinator role was undertaken by an experienced nurse who had developed individualised and comprehensive care plans for patients at risk of hospital admission. When necessary the care co-ordinator visited these patients at home to ensure care plans remained current so that these patients received timely and appropriate support.
• The PPG was working with a nearby charity to look at how they could work together in order to improve outcomes for older patients. The PPG had visited the local charity and volunteers from the charity were due to attend a PPG meeting to see how older patients in the community could be better supported.

The areas where the provider should make improvement are:

• Review the appointment system to ensure the care needs of all population groups are met.
• Review how infection prevention audits are carried out to help ensure effectiveness.
• Review how near misses are recorded in the dispensary to help reduce the risk of errors in the future.
• Review standard operating procedures(SOPs) to ensure they contain a date for future review.
• Revise the system that identifies patients who are also carers to help ensure that all patients on the practice list who are carers are offered relevant support if required.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice