Friarsgate Practice

We decided to undertake an inspection of Friarsgate Practice following our annual review of the information available to us. This inspection looked at the following key questions of:

• Are the services at this location effective?
• Are the services at this location well-led?

The practice’s annual regulatory review did not indicate that the quality of care had changed in relation to Safe and Caring. As a result, the ratings from the practice’s previous inspection from 2014 still stands in those key questions.

During the inspection, based on what we found on inspection, we decided to also inspect the key question of:

• Are the services at this location responsive?

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and outstanding for providing responsive services. We have also rated the practice as outstanding for the population groups relating to older people, people with long-term conditions and family, children and young people. The population groups relating to care of working age people, people with mental health and circumstance who make them vulnerable have been rated as good.

We found that:

• Patients received effective care and treatment that met their needs.
• The practice had implemented a new diabetic care programme to ensure consistent oversight of patient care and to improve its exception reporting performance but the impact of these changes had not yet been demonstrated.
• The practice had planned, organised and delivered services in innovative ways to meet patients’ needs.
• Patient feedback confirmed access to appointments was easy and they were able to access urgent and routine appointments when they needed them.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
• Staff were proud to work at the practice but some staff were not always able to attend practice meetings to contribute ideas for improvements or developments.
• The practice responded to significant events, complaints and concerns in a timely manner. Any subsequent investigations were comprehensive and patients received a full explanation where appropriate.

We saw the following areas of outstanding practice which contributed to the outstanding rating for responsive:

• By recruiting a chiropractor and running a MSK pilot, the practice had responded to national increased demand for MSK care and treatment. Since the pilot in 2018, 387 patients had been seen by the practice’s chiropractor. Of those, 61% had been discharged with self-management advice, 15% had received a prescription, approximately 25% had been referred for further investigation or for a secondary care follow up and 17% had returned for a follow up with the practice’s chiropractor.

• The practice had proactively introduced new systems, processes, workforce arrangements and technology to ensure access to care took account of people’s individual needs including those with urgent clinical needs as well as routine needs.

Whilst we found no breaches of regulations, the provider should:

• Develop a log of GP training records to ensure full oversight of completion performance in line with practice’s own training recommendations.
• Continue to review performance data, particularly exception reporting rates from Quality and Outcome Framework indicators, especially in relation to diabetes.
• Continue to improve the uptake for cervical screening to achieve the national target of 80%.
• Consider how staff from both sites can be included in relevant practice meetings to allow all staff members equal opportunities in contributing to learning and practice development.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care