Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Nailsea Family Practice on 6 December 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.
• 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 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 and was well equipped to treat patients and meet their needs.
• 91% of patients said they could get through easily to the practice by phone (compared with the national average 73%).
• The practice worked closely with patient volunteers to improve care. For example, a voluntary service worked with the practice in order to identify patients in need and otherwise unable to attend, and arranged transport to the practice and the local hospital.
• The practice hosted a range of talking therapy services for patients who had experienced bereavement, were carers, or were experiencing mental health issues. The services were funded by the local clinical commissioning group (CCG) and were available on referral. For example, the practice worked closely with organisations such as Positive Steps, Addaction and Wellspring.
• The practice participated in a social prescribing scheme to support patients who attend their GP surgery but did not necessarily require medical care. Social prescribing supported patients with issues such as social isolation and coping with caring responsibilities, to connect to services and groups that could help improve their wellbeing and meet their wider needs.
• Staff had lead roles that improved outcomes for patients, such as a carer’s champion.
• The practice received almost 100% of the points available (558.5 from a total of 559) for the Quality and Outcomes Framework (QOF). QOF rewards practices for the provision of 'quality care' and helps to fund further improvements in the delivery of clinical care.
• 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.
• When there were unintended or unexpected safety incidents, patients received reasonable support, truthful information, a verbal and written apology and were told about any actions to improve processes to prevent the same thing happening again.

We saw two areas of outstanding practice: 

• There were several examples of the practice proactively working with its patient participation group (PPG) to make changes to the practice and raise awareness of patients. For example, liaison with a local school to explore ways to improve services for young people; Health Awareness Days held on Saturday mornings; and

  evening education sessions held for patients.

• The practice was proactive in helping to establish Nailsea District Leg Club and we saw evidence of improved clinical outcomes and social benefits for patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice