Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Yadava Practice on 16 May 2017. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an effective system in place for reporting and recording significant events. Staff confirmed discussions had been held and lessons learnt. We found evidence to demonstrate how learning had been shared and changes embedded into practice.
• Patient safety and medicine alerts had been appropriately responded to.
• 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.
• We found the practice had allowed non-prescribers who had not received appropriate training, to carry out medicine reviews. The practice was reviewing their staff access and authorisation for non-prescribers.
• All staff had received a Disclosure and Barring Service (DBS) check and an appraisal within the last 12 months.
• We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.
• We found that staff had a good understanding of key issues such as safeguarding, mental capacity act and consent.
• All practice policies and protocols were practice specific, updated and reviewed.
• The practice had identified 44 patients as a carer which was 0.8% of their patient list.
• Information about how to complain was available and easy to understand. Complaints were responded to at the time of reporting where possible. Learning from complaints was shared with staff.
• The practice had a clear vision and strategy to deliver high quality care and promote good outcomes for patients. Staff were clear about the vision and their responsibilities in relation to it.
• The practice worked with their clinical commissioning group (CCG) to provide essential primary care to vulnerable adults within a domiciliary setting.
• The practice proactively sought and valued feedback from staff and patients, which it acted on. The patient participation group was engaging and active.
• There was a clear leadership structure and staff felt supported by management. The practice held regular staff meetings. We found clinical meetings were not being carried out regularly.
• The practice had reviewed their national GP survey results and was reviewing areas of improvement.
• The practice had good facilities and was well equipped to treat patients and meet their needs.

Actions the practice SHOULD take to improve:

• Ensure only qualified prescribers conduct medicine reviews and where appropriate staff have suitable training to carry out prescribing duties.
• Ensure only qualified prescribers conduct medicine reviews and where appropriate staff have suitable training to carry out prescribing duties.
• Strengthen quality improvement processes relating to national guidelines for gestational diabetes.
• Review process and methods for identification of carers and the system for recording this to enable support and advice to be offered to those that require it.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice