Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at the Riversdale Surgery on 15 November 2016. Overall, the practice is rated as good.
We found the practice had made a number of improvements since our previous inspection, on 29 July 2015, when they were rated as requires improvement. Our key findings across all the areas we inspected were as follows:
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Staff had taken action to address the concerns we had previously identified regarding the lack of governance in relation to the management of potential health and safety risks, and a failure to ensure staff had completed appropriate training. However, during this inspection, we found the arrangements for managing medicines were not always effective. Otherwise, all other risks to patients’ safety were effectively managed.
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There was an open and transparent approach to safety and an effective system for reporting and recording significant events.
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Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Services were tailored to meet the individual needs of patients and were delivered in a way that ensured flexibility, choice and continuity of care.
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Clinical staff had the skills, knowledge and experience to deliver effective care and treatment.
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The practice used the information collected for the Quality and Outcomes Framework (QOF), and their performance against national screening programmes, to monitor and improve outcomes for patients. The QOF data, for 2014/15, showed the practice had performed very well in obtaining 99.6% of the total points available to them, for providing recommended care and treatment. (Just before we published this report, the QOF data for 2015/16 was released. This showed that the practice had achieved an equally good QOF performance, with an overall achievement of 99.3% compared to the local Clinical Commissioning Group average of 98.2% and the national average of 95.3%.)
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There was a strong patient-centred culture. Patients were treated with compassion, dignity and respect.
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The practice and its branch surgery had good facilities and were well equipped to treat patients and meet their needs.
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Clinical leadership encouraged openness and transparency, and promoted an open culture, where staff felt well supported.
We saw one area of outstanding practice:
- Data from the NHS National GP Patient Survey of the practice, published in July 2016, showed patient satisfaction with access to appointments, was very good. For example: 99% of patients said the last appointment they got was convenient, compared to the local Clinical Commissioning Group (CCG) average of 93% and the national average of 92% 94% said they were able to get an appointment to see or speak to someone the last time they tried, compared with the local CCG average of 86% and the national average of 85%; 81% said they usually waited 15 minutes or less after their appointment time, compared to the local CCG average of 73% and the national average of 65%. In addition, patients were very satisfied with the caring approach of staff. For example, 97% said they found receptionists at the practice helpful, compared to the local CCG average of 89% and the national average of 87%.
The areas where the provider must make improvements are:
Ensure medicines are managed safely and appropriately. Specifically, make sure there are rigorous systems in place for ensuring:
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Patient Specific Directives and Patient Group Directions are used in line with national guidance.
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Staff follow the practice’s policy regarding the storage of medicines at the required temperatures.
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Prescription pads are stored securely in line with national guidance.
However, there were also areas where the provider should make improvements. The provider should:
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Record all dispensing ‘near-misses’, including those highlighted by the accuracy checking scanner used as part of the dispensing process.
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Improve how the practice identifies patients who are also carers.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice