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Inspection carried out on 27 November 2018

During a routine inspection

This service is rated as Good overall. (Previous inspection 8 December 2016 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at The GP Support Team on 27 November 2018 as part of our inspection programme.

At this inspection we found:

  • The service had good systems to manage risk so that safety incidents were less likely to happen. When they did happen, the service learned from them and improved their processes.
  • The service 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 service monitored care and treatment through peer sampling of patient records using the Clinical Guardian audit tool.
  • Patient feedback indicated that staff involved and treated people with compassion, kindness, dignity and respect.
  • Patients were able to access care and treatment from the service within an appropriate timescale for their needs. The incorporation of nationally recognised assessment tools into triage and assessment ensured patients were appropriately prioritised according to individual needs and that only appropriate patients were accepted into the service
  • Staff felt well supported by management in an open and transparent culture.
  • There was a focus on continuous learning and improvement at all levels of the organisation. Patient pathways developed in conjunction with secondary care were designed to optimise patient outcomes in a timely manner.

The areas where the provider should:

  • Review systems to gain evidence, of impact from clinical audit and assurance that the processing of urgent referrals is effective.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 8 December 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the BrisDoc Healthcare Services Limited GP Support Team (GPST) on 8 December 2016.

Overall the service 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 recording, reporting and learning from significant incidents.

  • Risks to patients were assessed and well managed.

  • Patients’ care needs were assessed and care delivered in a timely way according to need.

  • 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.

  • There was a system in place that enabled staff access to patient’s own GP records, and the staff provided other services, for example the referring GP, with information following contact with patients.

  • Patients’ feedback indicated 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.

  • The service worked proactively with other organisations and providers to develop services that supported alternatives to hospital admission where appropriate and improved the patient experience.

  • The service had good facilities and was well equipped to treat patients and meet their needs.

  • There was a GPST taxi service for patients who had difficulty in attending the service, which was funded by the Clinical Commissioning Group.

  • There was a clear leadership structure and staff felt supported by management. The service proactively sought feedback from staff and patients, which it acted on.

  • The provider was aware of and complied with the requirements of the duty of candour.

The area where the provider should make improvement are:

  • The provider should develop the patient information leaflet, which includes information about chaperones, so that it provides clear guidance about the service provider and type of service patients can expect.

We saw an area of outstanding practice:

  • The provider had developed its governance systems to ensure that quality was systematically embedded across the organisation. The Clinical Guardian system was a key mechanism by which clinical practice and standards were reviewed, monitored and maintained in the GPST. We saw working examples of how 'Clinical Guardian' was used to monitor performance and supervise clinicians. The provider had invested in GP time to conduct the Clinical Guardian reviews. Where potential concerns were identified on a call or patient record, then the case was subject to additional scrutiny by a peer panel review. Following the Francis Inquiry report (2013) audits had included patient safety, risk and clinician performance in relation to the patient disposition and outcome.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice