Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Manor Field Surgery on 29 October 2015. Overall the practice is rated as good.
Our key findings across all the areas we inspected were as follows:
- Staff understood their responsibilities to raise concerns, and to report incidents and near misses.
- There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. However, a significant event log was not maintained to ensure outcomes had been achieved.
- Although risks to patients who used services were assessed, the systems and processes to address these risks were not implemented well enough to ensure patients were kept safe. For example, systems to ensure the safe storage and use of medicines were not always implemented by GPs in respect of medicines held by them. There was no system in place to ensure that action was taken in response to medical alerts and a log was not maintained to monitor this.
- 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.
- Patients said they found it easy to make an appointment with a named GP and that 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.
- 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 registered provider was aware of and complied with the requirements of the Duty of Candour.
We saw one area of outstanding practice:
The practice had taken a number of measures to ensure patients could access the surgery easily and to improve the range of services provided. The practice had introduced an increased number of health care assistant (HCA) hours over five days to provide more access to routine and urgent phlebotomy services and other procedures undertaken by the HCA. Patients could access a HCA from 8.00am to give more flexibility to patients who worked or who needed an early morning appointment. They told us they had found this beneficial for patients who required bloods to taken after a period of fasting.
The practice had a high prevalence of patients with respiratory conditions. A practice nurse had been recruited with skills in asthma and chronic obstructive pulmonary disease (COPD) to address lengthy waiting times for patients to see a respiratory nurse at secondary care services. Nursing hours had been extended to provide more late afternoon and evening surgeries over five days per week to give patients more choice of appointment time and to reduce the waiting time to see a nurse for respiratory reviews. The nurse practitioner was introducing additional minor illness clinics to complement the GP role by seeing patients with conditions within her remit which would otherwise have been seen by a GP.
Results from the national GP patient survey showed that patient’s satisfaction with how they could access care and treatment was above local and national averages.
Patients told us that they found it easy to get appointments when they needed them. Parents said that the urgent services for children were very good and other patients said the telephone consultation service was also very good.
The areas where the provider must make improvement are:
The areas where the provider should make improvement are:
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice