Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Shaftesbury Practice on 18 October 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. The practice held monthly all staff meetings where discussion and shared learning on these events took place.
• A wide range of complete cycle clinical audits demonstrated quality improvement. There had been 28 clinical audits in the past two years.
• Risks to patients were assessed and well managed throughout the practice.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff training needs analysis had been undertaken and the results implemented. Staff had the skills, knowledge and experience to deliver effective care and treatment. Management had undertaken a staff training needs analysis and provided appropriate training for staff. There were six advanced nurse practitioners.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. All of the feedback from patients was positive.
• Information about services and how to complain was available and easy to understand. The practice carried out an annual complaint audit, the findings of which influenced shared learning events and 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.
• The practice had good facilities which were spacious and 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 identified an area of outstanding practice:

The practice employed a community psychiatric nurse (CPN) as a nurse practitioner at the practice for two days a week. This member of staff maintained close links with the local NHS Mental Health Trust through working there three days a week. The CPN supported patients with a wide range of mental health issues both at the practice and during home visits. The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the preceding 12 months was 92% which was comparable with the CCG average of 92% and higher than the national average of 88%. They provided us with examples of individual cases where they had used their mental health expertise to support patients with their medical care and treatment to avoid relapses in their mental health. They also helped to carry out physical health checks for patients receiving anti-psychotic medicines to reduce the risk of these patients gaining unhealthy weight.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice