Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at 15 March 2016. Overall the practice is rated as good for providing safe, effective, caring, responsive and well-led care for all of the population groups it serves.

Our key findings across all the areas we inspected were as follows:

• The practice was aware of and complied with the requirements of the duty of candour (being open and transparent with people who use the service, in relation to care and treatment provided). The partners encouraged a culture of openness and honesty, which was reflected in their approach to safety.

• All staff were encouraged and supported to record any incidents. There was evidence of good investigation, learning and sharing mechanisms in place.

• There was a clear leadership structure and a stable workforce in place. Staff were aware of their roles and responsibilities and told us the GPs and practice manager were accessible and supportive.

• Risks to patients were assessed and well managed. There were good governance arrangements and appropriate policies in place.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.

• Information regarding the services provided by the practice was available for patients.

• The practice had good facilities and was well equipped to treat and meet the needs of patients.

• There was a complaints policy and clear information available for patients who wished to make a complaint.

• Patients said they were treated with compassion, dignity and respect and were involved in care and decisions about their treatment.

• Patients were positive about access to the service. They said they found it easy to make both emergency and routine appointments.

• Longer appointments were given to those patients requiring interpreter services.

• The practice sought patient views how improvements could be made to the service, through the use of patient surveys, the NHS Friends and Family Test and their patient representative group (PRG).

• The ethos of the practice was to deliver good patient centred care.

We saw an area of outstanding practice:

• Collaboration with the local Aire Valley Medical Group a local ‘Hub’ of four practices in which Rawdon surgery is the lead practice. This had enabled seven day availability for appointments with both GPs and Nurses for all patients at the practices. It has also initiated a focus on the most vulnerable patients identified by putting in place three care coordinators and dedicated admin staff to ensure these patients are promptly and effectively supported with both their social and health care needs.

• The practice meets weekly with all staff to discuss and analyse incidents and significant events. This is called the ‘Huddle meeting’ and all staff were encouraged to raise any areas of concern. This ran alongside the sharing of safety events with other local practices via an electronic database. This shared learning, heightened awareness and increased transparency.

• Online systems used by the practice enabled patients to make appointments, order prescriptions, access their test results and the practice was piloting on- line access to patients records with 10% of patients presently accessing their medical information.

• A screening programme for impaired glucose tolerance (sometimes called pre-diabetes) had been initiated and run by the practice. This had identified additional patients in need of diabetic care and provided a programme of support.

• The practice worked in partnership with the Patient Empowerment Project (PEP) initiated by West Leeds Clinical Commissioning Group (CCG). This was to provide a link to services in the community which can provide support to the patients for instance with mental health, visual impairment problems and put them in touch with local based support groups.

However, there were areas of practice where they should make improvements:

• Ensure systems are in place for testing the on-going safety of electrical equipment and electrical and gas safety in the building.

• Review infection control throughout the building to ensure that audits are updated and action completed.

• Ensure all staff receive an annual appraisal.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice