Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at St Albans Surgery on 15 June 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 did not always find it easy to make an appointment, although there was continuity of care, with urgent appointments available the same day. Patient satisfaction with access to the service in both national and practice surveys was low.
• 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.

The areas where the provider should make improvement are:

• Monitor and continue to take action to improve patient satisfaction with access to the service, as demonstrated in the national GP patient survey.

• Review and improve how patients with caring responsibilities are identified and recorded on the clinical system to ensure that information, advice and support is made available to them.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

This practice is rated good for providing responsive service. (Previous rating for responsive 06 2017– requires improvement)

The key question at this inspection is rated as:

Are services responsive? – Good

We carried out an announced comprehensive inspection at St Albans Surgery on 15 June 2017. The overall rating for the practice was good, however responsive key question was rated requires improvement. The full comprehensive report on the June 2017 inspection can be found by selecting the ‘all reports’ link for St Albans Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 18 June 2018 to confirm the practice had carried out their plan to meet the legal requirements in relation to the breach in regulation that we identified at our previous inspection on 15 June 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

At this inspection we found:

• At the inspection of June 2015, the practice was not proactive in identifying patients with caring responsibilities. This was because they had identified 46 patients as carers which represented less than 1% of the practice’s population. At this inspection, we found this had significantly improved; 126 patients were now identified and recorded as carers and the practice manager maintained the carer’s register which was used to invite patients to attend influenza vaccines and annual health checks.
• We saw evidence the practice had taken steps to improve and monitor patient feedback in relation to how they accessed treatment and care.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.