Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Northdown Surgery on 23 August 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.
• 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.
• Patients said it was sometimes difficult to get through to the practice by telephone and to make an appointment with a GP. The practice was aware of this and after consultation with the patient participation group (PPG) and patients, were taking action. Urgent appointments were available on the same day for patients that needed them.
• Data from the national GP patient survey showed patients showed the practice was below local and national averages in some aspects of care. The practice was aware of these results and through consultation with the patient participation group (PPG) and patients, had formulated an action plan. The practice was in the process of implementing some of these actions at the time of the inspection.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The management structure had been recently restructured, including two joint practice managers, to reflect the changing needs of the practice. New lead roles had been created and staff felt supported by the new management team.
• The practice was responsive to the needs of older patients and gave equal importance to patients’ emotional and social needs alongside their physical and health requirements. The practice had collaborated with the local clinical commissioning group (CCG) in two projects aimed at improving outcomes for this patient population group.
• The practice were proactive in identifying and supporting carers and had 330 patients recorded on the carers register (3% of the practice list).
• The provider was aware of and complied with the requirements of the duty of candour.
• The practice team had recognised that it faced challenges linked with recruiting clinical staff and delivering services in an area that had a high prevalence of patients living in deprived circumstances. In response the practice was forward thinking and part of several local and national pilot schemes to improve services and outcomes for patients in the area.

The areas where the provider should make improvements are:

• Continue to improve systems and processes to monitor and recall patients with long-term conditions including diabetes, asthma and dementia.
• Continue to promote national screening programmes to help improve outcomes for patients.
• Continue, with the support of the patient participation group (PPG), to review and improve patients’ experience of the service, including in areas such as telephone access and access to GPs.
• Continue to review the staff appraisal systems to help ensure all staff receive regular support.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We spoke with 12 patients; this included eight active members of the virtual Patient Participation Group (PPG), and with clinical and non-clinical staff.

Patients were positive about the care and treatment they received at Northdown Surgery. One patient told us “The doctor I see is nice.” Another patient said “My doctor is lovely, I always get the treatment and reassurance that I need.” Patient told us that getting an appointment was not always easy. One patient told us “It’s not easy to get an appointment. You need to be on the phone at 8am on the dot and it’s not guaranteed you will get through before all of the appointments have gone.”

Patients received care that ensured their safety and welfare. Patients were assessed and treated by a GP or nurse practitioner and prescribed any medication they needed. There were systems in place to deal with medical emergencies. All staff had received basic life support training and there were emergency medicines and equipment available which was fit for purpose.

The provider had systems in place to protect patients against the risk associated with medicines. We looked at how medicines at the practice were obtained, stored, administered, recorded, monitored and disposed of. We found this was being carried out correctly and in line with current regulations.

There were effective recruitment and selection processes of staff in place.

The provider had procedures in place for dealing with complaints, comments and suggestions.