Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Queen Road Surgery on 1 August 2017. 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 a system in place for reporting and recording significant events.

• The practice had clearly defined and embedded systems to minimise risks to patient safety.

• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.

• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.

• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.

• Patients we spoke with 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.

• The practice had good 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.

• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

  We saw one area of outstanding practice:

A bespoke digital software tool was used by staff at the practice to improve safety and clinical outcomes and, in addition, enabled the practice to monitor recruitment and training. The system recorded all staff training and monitored the expiry dates clinical staff’s professional registrations. Searches were regularly run at the practice which highlighted staff who required training or which professional registrations needed to be checked. The system also enabled the practice pharmacist to ensure compliance with medicines safety alerts and that patient medicines were optimised in accordance with current best practice. In addition the practice used the software to analyse patient data to ensure those with long term conditions were identified, coded and called in for periodic reviews. As a result of the software’s analysis which looked at risk factors and patient medicines, the practice increased the number of patients on their asthma register by 29% and those on their pre diabetic register by 118% between April 2016 and August 2017. The software had also been used to generate information used for an audit of diabetic patients which show a significant increase in patients who had blood sugar levels within the optimal range.

The areas where the provider should make improvement are:

• Discuss the system used to triage patients with staff to ensure that all staff are aware of their roles and responsibilities.

• Take steps to ensure that Patient Group Directions include the practice name when these are renewed.

• Consider storing all practice policies in a single location to ensure that staff are able to access these easily.

• Continue to review staffing levels in the administrative team to ensure that there are sufficient numbers of staff.

• Take steps to monitor and mitigate risks to staff and patients including the risk of legionella.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice