Port Isaac The Surgery

We carried out an announced comprehensive at Port Isaac The surgery, and the two branch surgeries at St Kew surgery and Bridge Medical Centre on 23 and 24 January 2019 as part of our inspection programme.

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 good for all population groups. (Previous rating July 2016 – Good)

At this inspection we found:

• Feedback from patients about the staff, care and treatment was positive. National patient survey results regarding staff, care, treatment and the service were consistently higher than local and national averages.

• Patients appreciated the appointment system and said it was easy to use. Patients reported that they were able to access care when they needed it.

• Leaders communicated well, were knowledgeable about issues and priorities relating to the quality and future of services and participated in external groups to ensure they understood the local changes and challenges. The practice strategy was in line with health and social care priorities nationally and across the local area.

• The leadership team were aware of and involved in the future of General practice nationally and within Cornwall.

• The practice worked effectively with other practices in the locality.

• The new practice manager had reviewed governance process at the practice and addressed where they were not fully established.

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice recognised where systems and processes had worked well and improved their processes where appropriate.

• The practice had established and embedded systems in place to assess, monitor and manage risks to patient safety.

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

• The dispensaries, medicines, prescribing, high risk medicines were effectively managed.

• Staff involved and treated patients with compassion, kindness, dignity and respect.

• There was a strong focus on continuous learning and improvement at all levels of the organisation. Staff said the practice was a good place to work and added that the leadership team were supportive and encouraged career development and learning to help improve patient safety.

• There was evidence of systems and processes for learning, continuous improvement and innovation. The practice had taken part in many local pilots to test new methodology.

We found one area of outstanding practice:

The practice had recognised the geographical locations and isolation of the practice branches, the needs of the local population and associated restrictions for some patients accessing healthcare. The GPs and staff had reviewed this and offered additional support and services to reduce the need for long journeys, improved access to services. For example:

• Offering twice monthly rheumatology appointments for practice patients and those in the locality with a hospital consultant.

• Providing a home delivery service and phlebotomy service for housebound patients.

• Use of a community healthcare assistant (HCA) seconded to the practice who visited housebound patients to carry out blood tests, near patient testing and portable ECGs (electrocardiogram heart monitoring). The HCA visited elderly patients post hospital discharge.

• Providing same day interventions such as just in case bags and antibiotics to elderly patients in need who would otherwise require admission to hospital.

• Providing a women’s contraceptive and menopause service for patients by a GP with a special interest.

• Offering a physiotherapy service which enabled patients to access to physiotherapy services closer to home. The physiotherapy was offered within a purpose-built room with equipment provided by the practice. The practice also offered an equipment loan service and run regular Pilates classes.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice