Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Staffa Health on 17 September 2015. Staffa Health provides services from a main surgery at Tibshelf and three branch surgeries at Pilsley, Stonebroom and Holmewood. Overall the practice is rated as outstanding.

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

• The practice had robust arrangements in place to deal with information about safety. Staff were aware of their responsibilities to report incidents and concerns and knew how to do this. Information about safety was thoroughly documented and monitored. The practice had systems in place to maximise learning from significant events and incidents.
• Risks to patients were assessed and well managed across the four practice sites. Staff could access information about health and safety online or via the staff health and safety noticeboard.
• The practice demonstrated the use of best practice guidance to assess patients’ needs and plan their care. Staff had received relevant role specific training and further training needs were identified through an appraisal system and a training needs analysis.

• Feedback from patients was positive about the practice. Patients told us they were treated with dignity and respect and supported to make decisions about their care and treatment.
• The practice had developed clear and accessible processes to encourage patient feedback. Information on changes made as a result of patient feedback was shared with patients on noticeboards in the waiting area. The practice encouraged feedback from patients.
• Feedback from patients demonstrated that there was good access to the practice. Pre-booked appointments were available up to five weeks in advance with urgent appointments available on the same day. Patients could access appointments at any of the four sites.
• The practice had good facilities and was well equipped to meet the needs of patients.
• There was a very clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

We saw several areas of outstanding practice:

• In response to high rates of emergency admissions linked to falls, the practice had introduced the Otago Falls Prevention programme. This had a positive impact on the practice patients and we saw evidence to demonstrate a decrease in the number of falls related admissions to hospital.

• The practice employed a care coordinator and a health needs support worker to ensure that multidisciplinary care their patients received was integrated and well-coordinated. This ensured an effective link between health services, social care services and the voluntary sector.

• The practice continuously improved the way it delivered services by proactively identifying learning from a range of sources. Sources included patient feedback, complaints, significant events and a rolling programme of audit.

• The practice ensured learning from significant events and complaints was maximised and shared with all staff. The practice had introduced a quarterly lessons learned newsletter for staff.

• The practice had a clear vision which was shared with staff and patients; we saw that this vision was reflected in the practice’s plans for the future and was central to the care provided to patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice