Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Park and St Francis Surgery on 13 November 2014. During the inspection we gathered information from a variety of sources. For example; we will spoke with patients, members of the patient participation group, interviewed staff of all levels and checked that the right systems and processes were in place.

Overall the practice is rated as good. This is because we found the practice to be good for providing well-led, effective, caring and responsive services. It was also good for providing services for older people, people with long term conditions, families, children and young people, working age people, people whose circumstances make them vulnerable and people experiencing poor mental health.

Our key findings 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.
• People’s needs were assessed and care was planned and delivered in line with current legislation. Staff had received training appropriate to their roles and any further training needs have been identified and planned.
• Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment. Information to help patients understand the services available was easy to understand. We also saw that staff treated patients with kindness and respect, and maintained confidentiality.
• Some patients commented on the long waiting times for routine appointments with their preferred GP. They confirmed that they could see a doctor on the same day if they needed. Patients in urgent need of treatment were triaged by the practice nurse and were offered a same day appointment if medically necessary. The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand.
• 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 patient participation group (PPG) was active.

We saw several areas of outstanding practice including:

• Research projects carried out by the practice had resulted in improved outcomes for patients. A mental health study ensured that patients with a diagnosis of depression received additional health screening.
• Patients suffering from poor mental health had benefitted from increased access to trained counsellors. This had resulted in a reduction in required GP appointments.
• GPs referred patients, with their consent to the patient participation group (PPG). A member of the PPG made contact and supported the patient to access the help they needed.
• GP partners took dedicated time as a team, away from the practice, to discuss ways of making improvements to the practice. Common themes in the comments from patients had been discussed and acted upon.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

The practice accommodated the needs of people with disabilities. We saw that the building was wheelchair accessible and that the surgery consultation rooms were situated on the ground floor and first floor. There was lift access to the first floor. Part of the reception desk was lowered to a height suitable for people using wheelchairs. There were designated disabled parking bays close to the building entrance.

11 of the 12 people we spoke with were complimentary about the care and treatment they received at the practice. One person said: “My GP has been absolutely brilliant in supporting my long-term health issues” Another described their GP as “excellent”. A further person said: “I visit the nurse regularly and they’re really helpful” The other person we spoke with described their general satisfaction with the surgery but described a recent occasion where they had been unhappy that their GP had not prescribed a particular medicine they wanted.

Reviews of patients medicines were carried out annually or earlier according to patient need. From a review of patient notes we saw that allergies were clearly shown on the system enabling GPs to prescribe safely. This meant that medicines were prescribed and given to patients appropriately.

All clinical staff were required to provide evidence of their professional qualifications and registration. We saw that the GPs were on the Performer's List, which aims to provide further reassurance to members of the public that GPs practicing in the NHS are suitably qualified and have kept up to date with their training. All nursing staff were registered with the Nursing and Midwifery council (NMC) and copies of up to date registrations were held in their personnel files.

The provider took account of complaints and comments to improve the service. We saw that the practice had a clear complaints protocol in place. The registered manager told us that the practice rarely received complaints and that they sought to resolve these more quickly than the protocol specified. We saw written responses in relation to two complaints which showed they had been investigated and resolved.