This practice is rated as outstanding overall. (Previous inspection – 2 October 2014 – rating – good).
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Outstanding
Are services responsive? – Outstanding
Are services well-led? - Outstanding
We carried out an announced comprehensive inspection at Bellingham Surgery on 19 November 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.
- Feedback from patients who use the service was continually positive about the way that staff treated them. The practice provided an exceptional service where patients were truly respected and valued as individuals and were empowered as partners in their care. Staff were very good at involving patients in decisions about their care and treatment and treated them with compassion, kindness, dignity and respect. This was reflected in the very positive feedback the practice received from the national GP patient survey.
- The practice routinely reviewed the effectiveness and appropriateness of the care and treatment they provided. Staff ensured that care and treatment was delivered in line with evidence-based guidelines.
- Services were tailored to meet the needs of individual patients and were delivered in a way that ensured flexibility, choice and continuity of care.
- The practice encouraged learning and improvement, and staff had the skills, knowledge and experience to carry out their roles.
- The leadership, governance and culture within the practice were central to driving and improving the delivery of high-quality, person-centred care. The practice had a very clear vision to deliver high quality care and promote good outcomes for patients. This was supported by a highly effective business plan and business planning process. High standards were promoted and owned by all practice staff.
- Governance processes and systems for risk management, performance and quality improvement operated effectively.
We rated the practice outstanding for providing caring, responsive and well led services because:
- Patients’ individual needs and preferences were central to the practice’s delivery of tailored services. For example, leaders had reduced the risk of avoidable hospital admissions by actively engaging with a local scheme to give direct access to the local community hospital for people with an emergency healthcare plan. They had streamlined the recall process for annual health checks for patients with long term conditions (LTCs), which had lowered the number of missed appointments and increased the efficiency of the service. They had reinvested savings in clinician time to improve access to general appointments. This had supported an improved customer experience as reflected in the very positive feedback patients gave the service. The practice understood the challenges faced by patients living in a rural area. They had identified areas where there were gaps in the service locally and had taken steps to address these, by negotiating improved access for their patients. Staff actively engaged with the local community, to help ensure the surgery could stay open in adverse weather conditions and, so that vulnerable patients living in outlying rural areas could continue to receive a care and treatment.
- Patients could access services and appointments in a way and at a time that suited them. The practice’s performance on the National GP Patient survey was higher than both local and national averages, across all indicators relating to the responsiveness and timeliness of the service. For some of these, the performance was much higher than average and demonstrated a positive variation when compared to local and national averages. They had improved access for young people by providing targeted out-of-hours appointments at a clinic on a Thursday evening and implementing online consultations aimed at young people. They had attained the ‘You’re Welcome’ accreditation, which is a set of quality criteria aimed at supporting primary care to deliver young people friendly health services.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice