Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Swan Surgery on 24 May 2016. 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 report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example the practice worked with another GP practice nearby to provide specific support for young adults.
• Feedback from patients about their care was consistently positive.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. The practice worked closely with the local community hospital to provide medical cover for two wards which were designated ‘step-up, step down’ beds.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group. These included improving accessibility; reviewing and changing of appointment types and availability and improving IT systems to ensure information was easily shared.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice actively reviewed complaints and how they are managed and responded to, and made improvements as a result.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.

We saw one area of outstanding practice:

The practice carried out two emergency simulation exercises each year and findings from these were used to improve responses to emergencies. For example, the latest exercise carried out in May 2016 was for a baby with breathing difficulties. The practice found that response times were good and staff acted appropriately. Shortfalls were identified with equipment not being readily available As a result each day the practice identified a room for use in an emergency and nursing staff rechecked and tidied the emergency response bag.

However there were areas of practice where the provider should make improvements:

• Continue to review systems to make sure safety alerts are acted upon.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice