Archived: Tunbury Avenue Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Tunbury Avenue Surgery on 17 November 2015. Overall the practice is rated as good. Specifically, we found the practice to require improvement for providing safe services. It was good for providing effective, caring, responsive and well-led services.

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

• Urgent appointments were available the same day but not necessarily with a GP of their choice.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles.
• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they met people’s needs.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a result of survey responses and complaints received.

• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand.

• The practice had a clear vision which had quality and safety as its top priority. A business plan was in place, monitored, regularly reviewed and discussed with all staff. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

• There was a clear leadership structure and staff felt supported by management.

However there were areas where the provider should make improvements.

Importantly, the provider must:

• Ensure the practice is able to respond to a medical emergency in line with national guidance.

The provider should:

• Review procedures to ensure that all staff that do not have a disclosure and barring service (DBS) check are appropriately risk assessed, in order to ensure patient safety.

• Review the procedure for administrative staff acting as chaperones, in order to prevent the reception area being unmanned for any period of time.

• Review staff contracts (terms and conditions of employment) in order to ensure they are signed, agreed and dated by all parties.

• Review the fire evacuation procedure to ensure it includes supporting deaf, blind or disabled patients out of the practice in the event of a fire and make copies of the fire evacuation procedures available to patients.

• Review health promotion leaflets.

• Review the staffing structure to ensure that female GPs are available to patients.

• Review the timescale for implementing a clinical audit programme.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice