Letter from the Chief Inspector of General Practice
The practice has an overall rating of good.
We carried out an announced comprehensive inspection at Dr Thomas Guilder (also known as Riverbank Surgery) on 9 June 2015. Riverbank Surgery provides personal medical services to people living in Westcott and the Dorking area. At the time of our inspection there were approximately 2,000 patients registered at the practice with a team of a principal GP, a part time locum female GP, a practice nurse, a small team of receptionists / administration staff, a medical secretary and a dispensary manager. At the time of the inspection the practice manager’s position was vacant.
The inspection team spoke with staff and patients and reviewed policies and procedures. The practice understood the needs of the local population and engaged effectively with other services. Specifically, we found the practice to be good for providing well-led, effective, caring and responsive services. It requires improvement for safe. We found the practice was delivering a good service to all its different population groups.
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.
- Information about safety was recorded, monitored, appropriately reviewed and addressed.
- Risks to patients were assessed and well managed.
- Patients’ needs were assessed and care was planned and delivered following best practice guidance.
- Staff had received training appropriate to their roles and any further training needs had been identified and planned.
- Patients told us they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
- Patients spoke positively about how they were treated by staff. This was consistent with feedback from comment cards and patient surveys.
- Information about services and how to complain was available and easy to understand.
- Patients said they found it easy to make an appointment with the GP and that urgent appointments were available the same day.
- The practice was well equipped to treat patients and meet their needs.
- There was a clear leadership structure and staff felt supported by management.
- The practice proactively sought feedback from staff and patients, which it acted on.
- There were effective systems in place for the controlling the risk of infection. The practice was clean and hygienic.
- We found that some medicines and equipment for dealing with emergencies were not readily available
- There were effective system for ensuring that changes to patients medication following an outpatient appointment, A&E attendance or recent hospital stay were actioned in a timely manner
- There was close working with other dispensers from local practices to share training and best practice.
However, there were also areas of practice where the provider needs to make improvements.
Importantly, the provider must:
- Ensure equipment and medicines that may be required in an emergency are reviewed and made readily available where deemed appropriate.
- Ensure all staff working under Patient Group Directions (PGDs) are authorised to administer in line with national requirements (PGDs are written instructions for the supply or administration of medicines to groups of patients who may not be individually identified before presentation for treatment).
- Carry out regular fire drills
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice