Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Gold Street Surgery on 16 March 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. Outcomes from incidents were shared appropriately.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, the practice took part in peer review and attended post graduate meetings to update their knowledge of best practice.
• 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. For example, the practice was piloting a multidisciplinary meeting in one of the care homes, in order to improve communication between professionals involved in the resident’s care.
• 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. For example, following feedback from the NHS friends and family test the practice recruited two more salaried doctors.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice actively reviewed complaints and how they were managed and responded to, and made improvements as a result. Complainants were informed of the outcome and lessons learned from their complaint.
• 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.
• Continuous learning was encouraged at all levels both clinical and non-clinical. The practice was keen to maintain, involve and develop staff so there was a high level of satisfaction amongst staff and continuity for patients.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.

The areas where the provider should make improvement are:

• Consider taking more proactive steps to improve the identification of patients who are carers.
• Consider how they can improve patient access their preferred doctor.

We saw one area of outstanding practice:

• The practice had undertaken significant work with palliative care patients and patients on their multidisciplinary meeting list to establish decisions on preferred place of care and resuscitation wishes. They had worked with other agencies to ensure that patients end of life choices were fulfilled. The practice had completed an audit and found that 96% of patients had achieved their end of life preferences.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice