We carried out an announced comprehensive inspection at Orchard Surgery – BG Lannigan on 22 January 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and good for all population groups.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• There was equipment and medicines for use in emergencies and these were checked, however we found one item of medical equipment in a doctor’s bag had been missed from the previous year’s annual calibration.
• Blank prescriptions were logged in and out for use at the practice, however they were left in printers overnight and in unused rooms.
• Patients received effective care and treatment that met their needs. We saw that clinicians treated and cared for patients in line with current best practice guidelines and legislation.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care. There was evidence of clinical and internal audits being undertaken which demonstrated outcome improvements, however there was no formal audit programme based on national, local and service priorities.

Whilst we found no breaches of regulations, the provider should:

• Review the system for checking all medical equipment is serviced and calibrated as required.
• Review the storage of printer prescription pads in the practice to ensure they are secure at all times.
• Implement an audit programme that is based on national, local and practice priorities.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Orchard Surgery – BG Lannigan on 8 October 2015. 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 and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patient survey information showed that it could be a challenge to make an appointment with a named GP, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.

• The practice was clean and tidy.
• The practice used a pharmacy advisor to ensure the practice was prescribing in line with current guidelines.

• The practice sought patient views about improvements that could be made to the service, including having a patient participation group (PPG) and acted on feedback.

• Staff worked well together as a team and all felt supported to carry out their roles.

• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

The areas where the provider should make improvement are:

• The development of a centralised system to disseminate safety alerts and best practice guidance to all appropriate staff.
• To review policies and procedures at regular intervals.
• The development of an appraisal process for all staff.
• Ensure that the fire risk assessment is reviewed and updated.
• To support administration and reception staff to receive appropriate training to support them in their roles.
• Ensure that all clinicians are able to access safeguarding information from the computer system.
• Ensure the practice meetings standing agenda includes safeguarding.
• Ensure all staff receive Mental Capacity Act training.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice