Downton Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Downton Surgery on 13 October 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• 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.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice worked closely with a local charity that provided patient transport for practice and hospital appointments.
• 100% of patients with schizophrenia, bipolar affective disorder and other psychoses had their alcohol consumption recorded in the preceding 12 months, which exceeded both the clinical commissioning group (CCG) average of 93% and national average of 90%.
• 100% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in their records in the preceding 12 months, which exceeded the national average of 88%.
• Patients had access at the practice to drop-in clinics from outside agencies such as those specialising in bereavement care.
• The practice was proactive in ensuring that vulnerable patients who did not attend their scheduled appointments were contacted by the practice nurse, assessed and if necessary booked for a same day appointment at the practice.
• 91% of patients found it easy to get through to the practice by telephone compared with the national average of 73%.
• 87% of patients were able to get an appointment to see or speak to someone the last time they tried compared with the national average of 76%.
• The practice was proactive in addressing patient need by helping to develop a ‘Virtual Ward’ for patients aged 75 years and over who are considered to be at risk of unplanned hospital admissions. The Virtual Ward is a weekly meeting with the GPs and community health team and enables medical, nursing and social care to be directed appropriately. The Virtual Ward consists of a maximum of 30 patients at any point in time.
• The provider was aware of and complied with the requirements of the Duty of Candour.
• When there were unintended or unexpected safety incidents, patients received reasonable support, truthful information, a verbal and written apology and were told about any actions to improve processes to prevent the same thing happening again.
• The practice hosted a talking therapy service for patients who had experienced bereavement, were carers, or were experiencing mental health issues. The service was funded by the CCG and was available on referral.

We found one area where the provider should make improvements:

• The provider should seek support to recruit more members to its patient participation group, to better reflect the patient population it serves.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice