Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Quakers Lane Surgery on 7 July 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 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 worked with other health care professionals to understand and meet the range and complexity of patients’ needs.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Patients said they felt the practice offered an excellent service and staff were helpful, caring and treated them with dignity and respect. We received a wide range of examples to demonstrate how the practice had supported patients well through difficult circumstances.
• 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 they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• 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.
• There was a strong focus on continuous learning, innovation and improvement at all levels.

We saw some areas of outstanding practice:

The practice’s care of older people. The practice was working with two other practices as part of a frailty pathway project. The project was in phase one. The outcome aims of the project included areas such as improved patient satisfaction and quality of life, and improved recognition and diagnosis of frailty. The project was in phase one. Early outcomes clearly demonstrated the aims of the project were being worked towards and that appropriate care and referrals were made to support these patients. For example, of the 33 patients identified for the project 12 had been referred to the falls service, five to the Community Mental Health Team due to significant memory problems, 15 to a geriatrician for a more comprehensive assessment and one patient referred to the Voluntary Sector to provide a be-friending service.

The practice provided medical care to a local community hospital. They had access to six intermediate beds and provided medical care for their own patients who they directly visited. The practice also provided care for patients admitted to this hospital who were not their patients and out of area.

The practice offered a range of services as part of the ‘Out of Hospital Basket’ enhanced service aimed at providing care closer to the patient’s home and avoiding unnecessary travel to hospital. For example ring pessary fitting and replacement.

The practice offered ‘E-Consult’ an electronic way for patients to communicate with GPs for routine queries. This was of particular benefit for this semi-rural practice.

The areas where the provider should make improvements are:

The provider should ensure that systems are in place to ensure training is completed and updated in a timely way.

The practice should ensure recruitment arrangements are in line with Schedule 3 of the Health and Social Care Act (HSCA) 2008. The practice must ensure that all the necessary employment checks are in place for all staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice