Archived: Summerhill Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Summerhill Surgery on 1 November 2016. Overall the practice is rated as requires improvement.

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

• There was an open and transparent approach for reporting and recording significant events. However, not all significant events contained sufficient detail and the practice was unable to demonstrate that outcomes and learning were consistently shared throughout the practice.
• Not all risks to patients were assessed and well managed. For example infection prevention and control, legionella risk assessments and medicines management.
• Blank prescription pads and forms were stored securely. However, the practice was unable to demonstrate that they had a system to track and monitor their use.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Information needed to plan and deliver care and treatment was not always available to relevant staff in a timely manner and accessible way through the practice’s patient record system and their intranet system.
• The practice was unable to demonstrate they had a consistently systematic approach to care planning.
• 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.
• Urgent appointments were available on the same day. However, patients said they sometimes found it difficult to book appointments with a GP when they needed them.
• Results from the national GP patient survey showed that patients’ satisfaction with how they could access care and treatment was below local and national averages.
• 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 sought feedback from staff and patients, which it acted on.
• There were a range of mechanisms to manage the governance of the practice; however, governance arrangements were not always effectively implemented.
• The provider was aware of and complied with the requirements of the duty of candour. The partners encouraged a culture of openness and honesty. The practice had systems for notifiable safety incidents. However, the practice was unable to demonstrate a systematic approach for sharing this information with staff to help ensure appropriate action was taken

The areas where the provider must make improvement are:

• Develop an effective system for sharing significant events and incidents to ensure lessons are learned.
• Ensure the practice has regard for national guidance on the prevention and control of infection.
• Ensure the practice has regard for national guidance on the management of medicines and develop systems to monitor blank prescription forms and pads, vaccine storage and ensure that there is a process for managing and acting on medicine alerts from the Medicines and Healthcare products Regulatory Agency (MHRA).
• Ensure risk assessment and management activities include all potential and actual risks to patients, staff and visitors.
• Review the process for care planning for frail and elderly patients and medicine management reviews for patients on multiple medicines to help ensure the safety and individual needs of these patients are being met.
• Review and improve patients’ experience of the service, including areas such as telephone access to services and access to GP appointments.

The areas where the provider should make improvement are:

• Review clinical staffing levels to help ensure patients have access to routine GP appointments.
• Review staff training to help ensure that all staff receive appropriate training such as Mental Capacity Act training.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice