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Inspection Summary

Overall summary & rating


Updated 5 April 2019

We carried out an announced comprehensive inspection at The Exchange Surgery on 5 March 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected

• information from our ongoing monitoring of data about services and

• information from the provider, patients, the public and other organisations.

This practice is rated as Good overall – Good in Safe, effective, caring, responsive and well domain and good for all population groups except for vulnerable people which we rated outstanding. (Previous rating July 2016 – Good)

We found that:

  • The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
  • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • The involvement of other organisations and the local community were integral to how services were planned and ensured that services met patient needs.
  • There was a proactive approach to understanding the needs of different groups of people and to ensure they received the care to best meet their needs, particularly those people who were vulnerable.
  • Improvements since our last inspection included, improved care for patients diagnosed with diabetes demonstrated by the annual national Diabetes audit and the employment of a clinical pharmacist to rationalise and optimise medicines management.
  • The practice had a policy of continuous improvement which had developed their services for vulnerable people and people experiencing poor mental health (including people with dementia) in particular.

The areas where the provider should make improvements are:

  • Continue to monitor and improve the uptake for childhood immunisation and for the cervical screening programme.
  • Continue to monitor and improve patients experience when telephoning the practice.
  • Take action to ensure staff have received appropriate immunisation.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BS BM BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Inspection areas
Checks on specific services

People with long term conditions


Families, children and young people


Working age people (including those recently retired and students)


People experiencing poor mental health (including people with dementia)


People whose circumstances may make them vulnerable