This practice is rated as Good overall. (Previous inspection March 2015– Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Spital Surgery on 15 May 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There were systems in place to mitigate safety risks including health and safety, infection control and dealing with safeguarding.
• 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 sought patient views about improvements that could be made to the service; including having an active patient participation group (PPG) and acted, where possible, on feedback.
• Staff worked well together as a team, knew their patients well and all felt supported to carry out their roles.
• There was a focus on learning and improvement at all levels of the organisation.
• The provider was aware of the requirements of the duty of candour.

The areas where the provider should make improvements are:

• Review the practice policies and procedures to ensure they are localised and specific to the practice. They should be reviewed and updated as necessary and include implementation and revision dates.
• Review the system for following up urgent referral appointments (including the two week wait rule appointments) to ensure patients receive timely secondary care appointments when needed.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr G G Francis & Dr J A Hortop, known as Spital Surgery on 7 January 2015. Overall the practice is rated as good.

Our key findings across all the areas we inspected 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.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that 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.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should

• Ensure recruitment arrangements include the completion of a Disclosure and Barring (DBS) check before commencement of work where required or have a risk assessment in place supporting their decision not to have this undertaken.  
• Ensure the lead safeguarding GP undertakes updated adult safeguarding training
• Ensure legionella testing of the building is undertaken
• Ensure doctors have available emergency drugs or have in place a risk assessment to support their decision not to have these available for use in a patient’s home.
• Review the storage of emergency medicines held at the practice to ensure that when needed they can be accessed swiftly and safely.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice