Archived: Lifton Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Lifton Practice on 12 May 2015. This was a comprehensive inspection. The practice is based at Lifton Surgery and provides general medical services to people living in the village of Lifton and surrounding villages in Devon. The practice has a dispensary on site, which we inspected. The practice has two branches at Lewdown village Hall and Bratton Clovelly village hall, with weekly sessions held on a Monday, for the treatment of simple conditions. We did not inspect either of these branches at this inspection. The practice provides services to a diverse population, covering an area of approximately 250 square miles.

At the time of our inspection there were 3386 patients registered at the service with a team of two GP partners. Lifton Surgery is a training practice. When we inspected there were no medical students on training placements at the practice.

Patients who use the practice have access to community staff including district nurses, community psychiatric nurses, health visitors, physiotherapists, mental health staff, counsellors, chiropodist and midwives.

Overall the practice is rated as GOOD.

Specifically, we found the practice to be good for providing safe, well-led, effective, caring and responsive services. It was good for providing services to older people, vulnerable people and people with mental health needs including dementia, people with long term conditions, families, babies children and young people and working age people.

Our key findings across all the areas we inspected were as follows:

• Patient satisfaction was higher than the national average Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• There was a strong commitment to providing well co-ordinated, responsive and compassionate care for patients. A named GP and practice nurse monitored the health and well being of older and vulnerable patients with a learning disability and/or complex mental health needs.
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care. Patients reported high levels of satisfaction and confirmed that routine and urgent appointments were available the same day and staff were flexible and found same day gaps for patients needing routine appointments.
• 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.
• Audits were used by the practice to identify where improvements were required. Action plans were put into place, followed through and audits repeated to ensure that improvements had been made.

We saw an area of outstanding practice including:

• The practice is the sole provider of general medical services to an adult social care nursing home for 24 patients with Huntington’s Disease (a complex progressive neurological disease). Huntingdon’s Disease is rare and opportunities to develop expertise across the county are limited for medical staff. One of the GP partners has developed expertise in caring for patients with this disease and works closely with a national centre for long term conditions providing expert advice to this centre. Patients with Huntington’s disease from across the UK are referred to this service.

The practice should

• Set up a Patient Participation Group to engage patients in the on-going development of the service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice