Letter from the Chief Inspector of General Practice
This practice is rated as Good overall. We previously inspected this practice on 24 March 2016 and rated it Good overall.
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Requires Improvement
Are services well-led? - Good
As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:
Older People – Good
People with long-term conditions – Good
Families, children and young people – Good
Working age people (including those recently retired and students – Good
People whose circumstances may make them vulnerable – Good
People experiencing poor mental health (including people with dementia) - Good
We carried out an announced comprehensive inspection at A W Surgeries on 12 March 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 had developed systems to safeguard children and vulnerable adults from the risk of abuse and staff were aware of these. These systems were being adopted by Dudley Clinical Commissioning Group (CCG) to use as a model for other practices to adopt.
- The practice regularly reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence based guidelines.
- Staff worked extensively with other health and social care professionals to deliver effective care and treatment. Separate and dedicated meetings were held for palliative patients, patients experiencing poor mental health and patients identified as at higher risk of hospital admission.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients found the access a problem, most notably when trying to contact the practice by telephone. Data from the national patient survey showed that 28% of patients described their experience of making an appointment as good.
- The management team were aware of the challenges the practice faced and had implemented plans to address them. For example, they had implemented plans to improve access with the procurement of a new telephone system and upskilling of existing staff.
- The leadership, governance and culture are used to drive and improve the delivery of high-quality person-centred care.
- There was a strong focus on continuous learning and improvement at all levels of the organisation.
- Staff we spoke with were aware of the practice’s vision to deliver a high quality, safe patient centred service. They were aware of their roles in achieving this.
We saw several areas of outstanding practice including:
- A single point of contact had been assigned to support patients and their families nearing end of life. The service offered a direct line for contact and an open door to those in need of support.
- A ‘wellness centre’ had been introduced to provide support for both registered and non-registered patients. Projects within the centre provided a support structure for patients living with life changing conditions.
- The practice had implemented a development plan for the diagnosis and treatment of dementia and committed to extensive training for clinicians and support for the carers of people with dementia.
- Members of the leadership team had been awarded for their work in primary care and support was provided to other practices. The practice used its resources to support primary care development and promote better outcomes for both its own patients and those within the Dudley area.
- A fibromyalgia project had been carried out to proactively support and manage patients with high attendances. Outcome data for the five patients who had completed the project showed a significant decrease in attendances at the surgery.
However there were areas of practice where the provider should make improvements:
- Explore ways to improve the uptake of vaccines for eligible patients.
- Continue to monitor the patient feedback on access following the implementation of the new telephone system.
- Ensure Patient Group Directions are completed.
- Review recruitment checks completed to ensure that they meet all requirements as set out in schedule three of the health and social care act.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice