11 May 2016
During a routine inspection
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Derwent Surgery on 11 May 2016. Overall, the practice is rated as good.
Our key findings across all the areas we inspected were as follows:
- Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Lessons were learned when incidents and near misses occurred.
- Risks to patients were assessed and well managed.
- 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.
- Most 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.
- Urgent appointments were available on the day they were requested. However, most patients told us that they had to wait two or three weeks for routine appointments and appointments with a named GP.
- Extended hours appointments were available Monday to Friday between 7:30am and 8am.
- 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 practice had engaged with the staff during the recent merger with another local practice, staff members had been part of the steering group for this merger.
- The provider was aware of and complied with the requirements of the duty of candour.
We saw one area of outstanding practice:
- The practice had adapted their clinical system to support effective care of patients at increased risk of acute kidney injury due the medicines the patient was prescribed. When a clinician recorded relevant symptoms, the system checked the medicines prescribed and displayed a visual alert during the consultation. This reduced the risk of patients suffering acute kidney injury.
The areas where the provider should make improvement are:
- The practice should continue to implement a system of staff appraisals as soon as possible to provide staff with a formal opportunity to discuss training, learning and development requirements.
- Review the arrangements for clinical audit in order to be able to demonstrate a clear link between audits and quality improvement.
- Continue to review patient access for routine appointments with a GP.
- Review their staff induction and recruitment process for the checking of clinical and non-clinical staff immunity status.
- Complete the process for appointing a registered manager for the merged practice in line with CQC guidance.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice