Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Topcliffe Surgery on 16 November 2015.

Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. The practice had clearly defined and embedded systems, processes and practices in place to keep people safe.
• 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.
• Feedback from patients about their care, their involvement in planning and making decisions about their care and treatment was overwhelmingly positive. We were provided with many examples to demonstrate the caring approach of the practice. The examples came from patients, CQC comment cards and staff. This feedback was aligned with feedback from the national GP patient survey results which were consistently significantly higher than the national averages for the areas above.
• Results from the national GP patient survey showed that patient’s satisfaction with how they could access care and treatment was significantly high, being above the CCG and significantly above the national averages. The data was significantly higher than the national average in respect of how well appointments ran to time, convenience and suitability of making appointments and getting through to the practice via the telephone. These results were aligned with the patient feedback we received.
• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand
• There was a 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 several areas of outstanding practice including:

• The practice provided numerous in house services and tests that would normally be undertaken in hospital as part of locally negotiated ‘out of hospital services bundle’. These services meant patients could be treated closer to home and this was of significant benefit due to the population of the area in their rural location. They also offered other additional services such as acupuncture and minor operations.
• Results from the national GP patient survey showed that patient’s satisfaction with how they could access care and treatment was significantly high, being above the CCG and significantly above the national averages. The data was significantly higher than the national average in respect of how well appointments ran to time, convenience and suitability of making appointments and getting through the practice via the telephone. These results were aligned with the extremely positive patient feedback we received.
• We were provided with many examples to demonstrate the caring approach of the practice. The examples came from patients, CQC comment cards and staff. This feedback was aligned with feedback from the national GP patient survey results which were consistently significantly higher than the national averages for the areas above.

• Flu vaccination rates for the over 65 year olds were higher than the national average at 86% compared to 73%. Flu vaccination rates for those patients at risk were higher than the national average at 68% compared to 53%.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider should:

• Have a programme of audit in place in order to ensure they complete full cycle audits.
• Act on their plan to address outstanding health and safety items such as the replacement of the fire alarm system and the upgrading of the downstairs patient toilet.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice