Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Whitley House Surgery on 8 March 2016. Overall the practice is rated as good. The practice is rated as outstanding for the care of older people.

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

• Patients were protected from abuse and avoidable harm as staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Risks to patients were assessed and managed. Information about safety was monitored, appropriately reviewed and addressed.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. There were multi-disciplinary team discussions to ensure patients’ care and treatment was coordinated and data showed that the expected outcomes were comparable to other surgeries in the area.
• Patients said they were treated with compassion and dignity 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.
• Patients said they could make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The premises were purpose built and maintained to an acceptable standard throughout the clinical areas. Access for disabled people was in place including parking for the disabled and washroom facilities.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group.
• There was a leadership structure. Staff were appropriately qualified and competent to carry out their roles safely and effectively in line with best practice. Staff received satisfactory supervision and appraisal and were supported to undertake their continual professional development. Clinical staff and doctors were supported to participate in training and development which would enable them to deliver good effective quality care.

We saw one area of outstanding practice:

• We were told that Whitley House was the lead GP practice in Chelmsford for the 100 day Frailty Challenge set up as an initiative by the CCG involving six other GP practices as a pilot to improve care for frail patients. In the first three months of the initiative the reduction in avoidable admissions for that cohort of patients, was 17% and these practices have shown a 4% reduction from 14/15 to 15/16. This compares with a 9% increase for all other practice, so a very significant difference. This way of working, with enhanced multi disciplinary teams and the involvement of patients completing a narrative about themselves and their needs, has resulted in the initiative being extended into long term care and is including joint work between primary and secondary care. The CCG have also recognised that this initiative has improved relationships between GP practices and health and social care partners.

The areas where the provider should make improvement are:

• Ensure that the system for checking the medicines carried by GPs when away from the practice is more robustly monitored. Ensure that there is an effective system for documenting the control of stock in relation to vaccines in use at the practice and their expiry dates. Ensure records of these checks are recorded.

• Ensure that all staff are aware of the issues affecting the practice including the objectives, performance and the learning from significant events and safety incidents.

• Ensure policies are up to date and reflect current practice.

• Improve the identification of patients who are carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We found the service to be welcoming with friendly staff. Practice information was displayed for people who used the service. This included health promotion, access to support and other available services. Appointments could be made in person at the surgery, by telephone, or using an on line system via the practice's website.

We spoke with eight people who all spoke very highly of the services provided to them. We also spoke with staff who said they enjoyed working in the practice. One told us, "I wouldn't work anywhere else, I love it here."

People's needs were assessed and care and treatment was planned and delivered in line with their individual wishes. One person said, "It’s brilliant!” Another person said, "Fantastic. I can't fault it."

We saw that there was a system to ensure repeat prescriptions were available promptly and medicines that were kept at the practice were stored safely.

Staff were supported through appraisal, informal supervision and staff meetings.