Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at St Michael’s Surgery on 13 April 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, recording and learning from significant events.
• The practice population has high levels of social deprivation with many examples of health inequalities including high numbers of multiple health problems. The practice deprivation index of 27.9% is significantly higher than the average for the Bath and North East Somerset region of 12% and the national average of 21.5%. The practice was working with the local health and care communities and agencies to try to redirect resources to those who need them.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Services are tailored to meet the needs of individual people and are delivered in a way to ensure flexibility and continuity of care.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. The practice recognised that the majority of its population accessed care in an unplanned way, and ensured opportunistic access, a high proportion of on the day appointments, and flexible services to meet the patient’s needs.
• The practice had recently undergone significant changes as the GP partner cover had unexpectedly reduced at short notice over the previous few months and a new practice manager had taken on the role two weeks before our visit. The practice staff were working together to review and update processes and procedures, and the practice was in the process of recuiting a new GP partner.
• Although there had been recent changes to the practice in the previous months, the practice reported a clear leadership structure and staff told us they felt supported by the management and that they valued the team and good communication within the practice.

• Risks to patients were assessed and well managed, although some policies were due to be reviewed.

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

• The provider was aware of and complied with the requirements of the duty of candour.
• The practice proactively sought feedback from staff and patients, which it acted on.

We saw one area of outstanding practice:

The practice had identified a need to improve care for patients with a borderline personality disorder, they developed a template/pathway guide which had been shared across the local area.

The area the provider should make improvement:

Ensure all staff receive regular appraisals and confirmation of the completion of mandatory training requirements.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We reviewed the information available to us about St Michael's Surgery on 14 May 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.