Letter from the Chief Inspector of General Practice
Western Elms Surgery is located in a converted building in West Reading. There are approximately 16,000 patients registered at the practice. We carried out an announced comprehensive inspection of the practice on 11 November 2014. We visited Western Elms Surgery during this inspection. This was the first inspection of the practice since registration with the CQC.
The practice has had significant changes to staffing over the last two years, specifically changes in the GP partners. The patient population is very transient and this means the patient list changes a great deal over time. The practice monitors its appointment system and is aware of some concerns among patients about the ability to book non-urgent appointments. The practice responds to changes in demands by auditing its appointment system when there is concern about the demand for appointments. Patients were able to make appointments when they needed them. The premises were accessible to patients with limited mobility and all clinical areas were located on the ground floor. Patients told us staff were caring, friendly and considerate. The practice patient participation group is involved in the running of the practice and has been involved in making changes to the practice. For example, they lobbied the local authority for on street disabled parking due to the shortage of spaces at the practice and achieved their goal.
We spoke with nine patients during the inspection. We met two of the patient participation group, three GPs, the practice manager, assistant manager, three members of the nursing team and administration staff.
Western Elms Surgery practice was rated good overall.
Our key findings were as follows:
Patients were mostly positive about the care they received from GPs and nurses. All the patients we spoke with or who provided feedback told us staff were caring. Some patients were concerned about the booking appointments with their GP, saying they may have to wait up to three weeks to see them, but that they could see other GPs when they needed. All patients we spoke with said they could book an urgent appointment. The practice had systems to keep patients safe including safeguarding procedures and means of sharing information about patients who were vulnerable. Western Elms Surgery was hygienic and infection control was monitored. The practice was well maintained and equipment was serviced. There was strong strategic leadership and a positive culture which encouraged learning and openness.
We saw one area of outstanding practice including:
- The practice had implemented an IT tool which assisted the practice in identifying patients at risk of unplanned admissions and 45 vulnerable patients per GP had been identified as requiring a care plan.
However, there were also areas of practice where the provider should make improvements.
The provider should:
- ensure nursing staff have an appropriate understanding of the Mental Capacity Act 2005.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice