Court Thorn Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Court Thorn Surgery on 4 October 2016. Overall the practice is rated as outstanding.

Our key findings were as follows:

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. All staff were involved in discussions about complaints and significant events. Managers were keen to ensure that staff had the opportunity to give their input and take an active role in agreeing any corrective action or learning points.
• Feedback from patients and their families about the way staff treated people was continually and overwhelmingly positive. Every one of the 15 patient CQC comment cards and the 33 ‘share your experience’ forms we received was very positive about the service experienced.
• Information about services and how to complain was available and easy to understand.
• Patients could access appointments and services in a way that suited them. Results from the National GP Patient Survey, published in January 2016, showed that patients’ satisfaction with how they could access care and treatment was much higher than local and national averages
• The practice was integrated in the local community; managers were aware of the problems faced by some people and provided appropriate support.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Leaders had an inspiring shared purpose, strove to deliver person centred care and motivated staff to succeed. There was a clear leadership structure in place and staff felt supported by management.
• The practice proactively sought feedback from staff and patients, which they acted on.
• Staff throughout the practice worked well together as a team.

We saw several areas of outstanding practice including:

• There were innovative approaches to providing care and support for patients. The practice had commissioned a self-care programme for patients with long term conditions. A specialist facilitated the sessions at the practice, and around 14 patients attended each of the modules. The programme was then made available electronically via email for all patients to access.
• The practice had established an effective patient participation group (PPG). Managers supported the PPG to organise a number of health seminars for patients; 11 had been held so far. Patients made suggestions as to which topics they would like to be covered, then the practice and PPG sourced speakers to attend. The seminars were advertised across the area and the previous event had been attended by 52 patients.
• All accident and emergency attendances for care home residents were reviewed monthly to help identify specific health needs or any safeguarding concerns. The number of attendances at accident and emergency for care home patients had reduced from 21 (January to August 2015) to 7 for the same period in 2016.
• There was a weekly prescription delivery service, run by the practice’s PPG. Many patients lived in isolated areas, without access to public transport. Each week throughout the year, a number of volunteers delivered medicines to patients at their homes. There were well established governance and management arrangements in place to ensure the effective running of the service.
• The practice had very good arrangements in place to ensure carers’ needs were met. Each month one of the nurses carried out a check of all carers on the practice register to ascertain if any further support or interventions were necessary. The practice worked closely with a local carers support group; the group held a drop in clinic once a month to provide support and encourage carers to register themselves. Feedback from the carers support group about the practice was very positive.

The area where the provider should make improvements is:

• Take steps to ensure medicines management processes are up to date and closely monitored.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice