Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at West Lodge Surgery on 21 September 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 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.
• 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.

We saw areas of outstanding practice:

• The practice manager had produced a training booklet to increase awareness of The Accessible Information Standard. The Accessible Information Standard came into force from 31 July 2016 and aims to make sure people with a disability, impairment or sensory loss have access to information which they can read or understand. The training booklet had been used by practices across the Pudsey locality.
• Information for patients about the services available was easy to understand and accessible. For example; the practice leaflet, complaints procedure and complaints form was available for patients in audio, braille and large print.
• The practice had a lead GP who ran a monthly learning disability clinic. The GP liaised with other sectors when co-ordinating annual care plans for learning disabled patients and integrated blood tests with dental, vision and ear checks if the patient required to be sedated for another purpose. Early dementia screening was also carried out as learning disabled patients can start to show signs of dementia from the age of 40. All physical examinations were co-ordinated to offer patients the least intrusive and distressing experience. The practice had installed acoustic panels to reduce the amount of echo in the building and assist patients who were hard of hearing.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

This practice is rated as Good overall but Outstanding for providing responsive services and requires improvement for the population group of people with a long term condition. (The previous comprehensive inspection was carried out in September 2016 when the practice was rated Good overall).

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Outstanding

Are services well-led? - Good

We carried out an announced comprehensive inspection at West Lodge Surgery on 7 June 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• The practice had been proactive in taking steps to meet the requirements of the Accessible Information Standard. This included development of a presentation and training document which was delivered and shared across West Leeds. The practice had information readily available in a range of formats including audio and braille.
• There was a strong focus on innovative practice and partnership working to improve population health in the community. For example; one of the GP partners had taken the lead on the Leeds West Pilot for Deep Vein Thrombosis Pathway.
• The practice was working in partnership with Yorkshire Ambulance Service to have a specialist paramedic to provide clinical care to patients in the community. The scheme was designed to provide help to improve aspects of care provided to patients; help GP surgeries with high workload and increase the skill level of the paramedics involved.

We saw areas of outstanding practice:

• GPs at the practice liaised with other sectors when co-ordinating annual care plans for learning disabled patients and, following discussions and agreement with the patient and their carers, would arrange for integrated multispecialty clinics to integrate blood tests with dental, vision and ear checks if the patient required these. Early dementia screening was also carried out as the practice recognised that learning disabled patients can start to show signs of dementia from the age of 40.

The areas where the provider should make improvements are:

• Review and improve the range of vaccinations and immunisations offered to staff in line with Department of Health Guidelines.
• Continue to review and improve quality and outcomes framework exception reporting, particularly around the care and treatment provided to patients with long term conditions.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice