Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Chorley Surgery on 23 August 2017. Overall the practice is rated as outstanding .

Our key findings were as follows:

• The practice had a strong vision, which put quality, effective care and treatment as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
• The partnership and management team were structured with distinct roles and responsibilities, utilising the experience and skills of each member to the full. As a result, all business and clinical matters were delivered effectively at the practice.
• The practice was committed to learning and development for its entire staff and used every opportunity provided by significant events, complaints, auditing and patient feedback as tools to drive improvement.
• A comprehensive communication strategy was in place, which included regular internal and external meetings. These provided opportunities to review patient outcomes, to share learning and development, and to review achievements and evaluate progress in meeting objectives.
• The practice had clearly defined and embedded systems to minimise risks to patient safety. There was an effective system in place for the reporting and recording of significant events. Significant events were investigated and learning outcomes were shared with the practice team to enhance the delivery of safe care to patients.
• Comprehensive systems were established to safeguard children and vulnerable adults.
• An active programme of clinical audit that reviewed care and ensured actions were implemented to enhance outcomes for patients was undertaken.
• Patients told us they were treated with compassion, dignity and respect. They also said they were involved in their care and decisions about their treatment. This was corroborated by the CQC comment cards and those patients we spoke with.
• The practice provided leadership and innovation in planning, co-ordinating and delivering new initiatives in patient care. They worked with the wider health and social care multi-disciplinary team to deliver effective and responsive care to keep vulnerable patients safe. Enhanced monthly multi-disciplinary meetings took place to discuss and review patients’ needs.

We saw areas of outstanding practice including:

• The bimonthly staff news bulletin was used as part of practice’s learning, development and communication strategy and provided comprehensive information for staff about the significant events, complaints and patients feedback received in the preceding two months and the changes implemented as a result of these.

• The GP partners had initiated and led an innovative pilot scheme working collaboratively and in partnership with five GP practices, the local authority, paramedics, and the Lancashire Wellbeing Services to provide a Primary Care User Support team (PCUST). The purpose of PCUST was to identify patients who frequently requested the use of primary care services (high intensity users) and to provide them with a personalised care and support programme. Other areas of collaborative work included the facilitation and leadership of a diabetic hub service. The Chorley Surgery provided clinical support treatment to their own patients with Type 1 and Type 2 diabetes (including complex cases) and the patients of the five GP practices they worked collaboratively with. The initial impact of the service enabled patients to be seen quickly within a three to four week wait at the diabetic hub as opposed to the secondary care waiting list of 20 weeks or more.

An area where the provider should make improvement is:

• Continue to identify and support patients who are also carers

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice