Sedbergh Medical Practice

We carried out an announced comprehensive inspection of Sedbergh Medical Practice on 10 August 2016. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• Risks to patients were assessed and well managed.
• The practice carried out clinical audit activity and were able to demonstrate good improvements to patient care as a result of this.
• Feedback from patients about their care was consistently positive. Patients reported that they were treated with compassion, dignity and respect. Patient feedback in relation to access was higher than local clinical commissioning group and national averages.
• Patients were able to access same day appointments during daily open surgeries. Pre-bookable appointments were available within acceptable timescales.
• The practice had a number of policies and procedures to govern activity, which were reviewed and updated regularly.
• The practice had proactively sought feedback from patients and had a doverse, actove and engaged patient participation group. The practice implemented suggestions for improvement and made changes to the way they delivered services in response to feedback.
• The practice used the Quality and Outcomes Framework (QOF) as one method of monitoring effectiveness and had achieved the maximum results available to them for 2014/15.
• Information about services and how to complain was available and easy to understand.
• The practice had a clear vision in which quality and safety was prioritised. The strategy to deliver this vision was regularly discussed and reviewed with staff and stakeholders.
• All GP appointments were scheduled for 15 minutes. All nurse appointments were scheduled for 30 minutes.

We saw areas of outstanding practice:

• The practice was participating in a video consultation pilot for some of their housebound and elderly patients living in more rural locations. This not only allowed patients to access timely consultations with a practice GP but also enabled more socially isolated patients to connect with other users of the system and access video games and puzzles.
• When the practice had to use a locum GP they were given a half day induction session to familiarise themselves with practice policies, procedures, systems and staff. Feedback we received from previous locum GPs was consistently positive and praised the practice for its access to appointments, patient safety systems, motivated and knowledgeable staff and robust policies and protocols.
• The practice was proactive in the development and application of care plans. Patients with a care plan were offered a 30 minute annual care plan review with a GP. The practice reported that of their patients who had died during 2015/16, 48% had an advanced care plan in place.

However, there were areas where the provider should make improvements. The provider should:

• Consider implementing an annual review of significant events and incidents and record and monitor who is responsible for carrying out action points from significant events.
• Review and improve the arrangements in place to log and monitor the movement and use of blank prescription pads
• Review out-of-date practice guidance used by the healthcare assistant when administering vaccinations under patient specific directions.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice