Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at AW Surgeries, Withymoor Surgery on 24 March 2016. Overall the practice is rated as good.

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

• Risks to patients were assessed and well managed. Patients’ needs were assessed and care was planned and delivered following best practice guidance. The practice had clearly defined and embedded systems, processes and practices in place to keep people safe and safeguarded from abuse.

• The practice was proactive in identifying and managing significant events. All opportunities for learning from internal and external incidents were maximised.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Clinical audits were carried out to demonstrate quality improvement and to improve patient care and treatment

• The practice had a regular programme of practice meetings and there was an overarching governance framework which supported the delivery of the practice’s strategy and good quality care. Governance and performance management arrangements were proactively reviewed to reflect best practice.

• Staff we spoke with said they felt valued, supported and that they felt involved in the practices plans. Staff worked with multidisciplinary teams to understand and meet the range and complexity of patients’ needs.

• The practice offered a range of clinical services which included care for long term conditions such as diabetes, a range of health promotion and the GPs also offered minor surgery to registered patients and for patients who were locally referred from their own GP. An in-house dermatologist worked with the practice on a weekly basis to offer general dermatology services.

• The practice offered proactive care to meet the needs of its population. The practice was focusing on a proactive and preventative care method and we saw how staff had conducted a thorough analysis across long term condition registers in order to improve current systems and care for patients with comorbidities.

• The practice proactively sought feedback from staff and patients, which it acted on. The practice had an active patient participation group which influenced practice development.

We saw some areas of outstanding practice:

• The practice had a dedicated children’s hour at 8:30am and 3:30pm for on call GPs to see children who for example, woke up unwell or were collected from school unwell. Staff explained that due to the popularity of this, appointments were increased to six morning appointments and six afternoon appointments for the GP on call to see children during this appointment window. Children under the age of five were also seen as a priority.

• Members of the management team held a number of outside posts; this was used to benefit the practice through shared learning and for leading on projects to benefit patients. For example, the practice were exploring ways of identifying vulnerable patients who may be in need of extra support, this included identifying any ex-military patients through a veterans health initiative. The veteran’s health initiative was developed by one of the practices GPs who had carried out research in to this area through their role as associate dean for the Black Country.
• An in-house dermatologist worked with the practice on a weekly basis to offer general dermatology services. Practice data demonstrated that 1754 appointments were offered to local patients and filled with the dermatologist during 2015, 308 of appointments were attended by patients of the practice. Use of this service avoided patients having to travel to other community clinics and secondary care services. 

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice