Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Robert Darbishire Practice on 3 November 2016. 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.
• The practice had good policies for the recruitment of staff.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• 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 provider was aware of and complied with the requirements of the duty of candour.

We saw the following areas of outstanding practice:

• The Quality Improvement Programme Manager who had created “QOF packs” for GPs. The pack was designed to give GPs better oversight over their administration role and allow better time management. Each GP was given a list of their patients who were missing clinical targets that made up the QOF. The GPs were instructed to review each patient’s record and decide on the best way forward and the Quality Improvement Programme Manager followed up all the actions on a monthly basis.
• A weekly clinic was set up for drug users. There were named lead staff with specialist training in partnership with the Community Drug Team. Staff had identified common issues in this patient cohort such as low screening and uptake of immunisations and due to the chaotic lives, this particular group of patients did not attend appointments. The practice staff had created a “one-stop shop” with a dedicated GP, nurse and healthcare assistant to provide a holistic approach.
• The practice was innovative and looking for ways to interact with the local communities and ran a number of projects such as for the local university population. The practice had liaised with the counselling services, was working to have a student Mental Health Forum and employed additional staff to register students at peak times. The practice participated in Arts projects to involve local schools and people and were looking to initiate a “Walking group” in association with Macmillan Cancer, the Ramblers association and local walking club Manchester Giants.
• A privacy slip was available at the reception for patients to complete discretely and present to the reception staff if they did not want to speak to the reception staff.

There was one area were improvement should be made:

• Consideration should be given to the improvement of activity undertaken to identify and register carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice