Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Spitalfields Practice on 22 March 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 except for some gaps in the management of fire safety and infection control.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they were able 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 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.

The areas where the provider should make improvement are:

• Review the cleaning arrangements for the practice and infection control audit to ensure all standards have been assessed accurately.
• Ensure there is an effective system for recording to whom prescription pads are issued.
• Ensure all staff have undertaken fire training and that the fire risk assessment is reviewed and updated.
• Consider how people who use the accessible toilet facility would alert staff in the event of an emergency.
• Display the appropriate warning sign on the door where the oxygen cylinder is stored.
• Monitor findings from the national GP patient survey relating to access to appointments via the telephone system and nurse consulations.
• Continue to monitor and improve the practice’s uptake for the cervical screening programme.
• Review how carers are identified and recorded on the clinical system to ensure information, advice and support is made available to them.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We spoke with two of the practice's GP partners, one salaried GP, a practice nurse, a nurse practitioner, the practice manager and her deputy, a patient's advocate, one healthcare assistant who was also a phlebotomist, and one member of the reception staff. We also spoke with nine people who used the service.

All of the people using the service told us their GP listened to their concerns and explained the treatment options available. One person told us they would like to be able to choose which doctor they can be registered with. Some people thought the appointment system could be improved. People's privacy, dignity and independence were respected. The practice ensured that people's cultural needs were being met, this included provision of interpreting services when needed.

People we spoke with told us of their experience of the practice. People told us that the clinical staff took time to discuss and explain their care and treatment. All the patients we spoke with were happy with the service they received from the practice. One person told us, "for the grace of Allah the service here is very good." Another person said, "ten out of ten, they work very hard."

People who used the service were protected from the risk of abuse, because the provider had taken some steps to identify the possibility of abuse and prevent abuse from happening.

Staff received appropriate professional development. Patients told us they had confidence in the knowledge and skills of the staff at the practice.

People who used the service, their representatives and staff were asked for their views about their care and treatment through the Patient Participation Group and they were acted on. We also looked at NHS Choices website and saw that people's comments had been responded to by the practice.