You are here

Inspection Summary


Overall summary & rating

Good

Updated 18 January 2018

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection October 2016 – Outstanding)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Swadlincote Surgery on 14 November 2017 as part of our inspection programme.

At this inspection we found:

  • The practice had good systems to manage risk so that safety incidents were less likely to happen. When they 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.
  • Clinicians followed national guidelines and protocols available to them in the identification and management of severe infections such as sepsis.
  • Staff involved and treated people with compassion, kindness, dignity and respect.
  • Patients found the appointment system easy to use and reported that they were able to access care at the right time.
  • The practice was a training practice and the partners were proud of their reputation for being a practice of choice for trainee GPs and other clinical roles.
  • Results from the latest national GP patient survey showed that the practice had performed above local and national averages in the majority of the questions about patient experience. This was particularly evident in relation to GP access and comments regarding being listened to and having tests and treatments explained.
  • Care planning was embedded within the practice to reflect individual patients’ needs and their own wishes. We saw that care plans were thorough and were used extensively for patients in care homes, those with complex needs and patients who were vulnerable.
  • The practice was responsive to patient’s feedback and had invested in a new telephone system with an additional line to improve access for appointment requests.
  • They had implemented a Medical Interoperability Gateway system (MIG) which enabled the sharing of specified datasets of patient information between healthcare providers in ‘real time’ to enable a more effective response for relevant healthcare professionals.
  • The practice utilised a care coordinator who worked with the practice and community team to identify patients who were at risk of unplanned admission to hospital.
  • The practice utilised data clerks to manage the recall system and free up time for nurses to manage their time more effectively. They contacted non-attenders by telephone to re-schedule their appointment
  • They had set up an internal Locum system to enable consistency of care for patients
  • The partners and practice staff were very proud of their reputation for being highly regarded as an excellent training practice and able to recruit new GPs and other clinical staff easily as trainees and also for permanent positions.
  • Some of the GP partners held strategic lead roles within the clinical commissioning group (CCG) which helped influence and drive improvement in the delivery of patient care within the locality.
  • The practice were proactive in identifying risk of falls and taking action to reduce this. All GPs used a fragility index score for patients at risk and created a care plan for those patients which was shared with relevant health care providers.
  • The practice had achieved dementia friendly status
  • The practice had created effective links with local schools and universities to assist young people who were interested in a medical career, as well as providing training and mentorship for GP Registrars and advanced clinical practitioner (ACP). They also worked collaboratively with Derbyshire Community Healthcare Services (DCHS) to provide training and mentorship for an additional ACP.
  • They had designed an ANP triage hub and were about to commence this as a pilot project. Patients would benefit by seeing an ANP with a specialism most suited to their symptom and would receive the most appropriate advice first time.
  • They had developed a support board in the reception area to assist patients who needed extra help in navigating health care systems and who were vulnerable but may not be on any other register. For example, patients who had an alcohol dependency and homeless people.
  • The practice had developed their own risk stratification tool within the clinical system to identify patients who were vulnerable for a variety of reasons.
  • The practice had recently set up a bereavement café to help bereaved relatives feel less isolated.
  • A workshop for new parents had been set up and due to commence the following week for the first time. The anticipated impact of this was that new parents would be better informed to manage their child’s health. This would potentially improve attendance for scheduled child health checks.

We saw an area of outstanding practice:

  • The practice worked with their local CCG to reduce waiting times for local mental health provision. This had resulted in a reduction in waiting times for patients to receive access to psychological therapies within six weeks from 66% to 76% of patients. Many were seen within four weeks of referral.

The area where the provider should make improvement are;

  • Ensure that all mandatory training updates are completed by relevant staff and are recorded centrally.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 18 January 2018

Effective

Good

Updated 18 January 2018

Caring

Good

Updated 18 January 2018

Responsive

Good

Updated 18 January 2018

Well-led

Good

Updated 18 January 2018

Checks on specific services

People with long term conditions

Good

Updated 18 January 2018

Families, children and young people

Good

Updated 18 January 2018

Older people

Good

Updated 18 January 2018

Working age people (including those recently retired and students)

Good

Updated 18 January 2018

People experiencing poor mental health (including people with dementia)

Good

Updated 18 January 2018

People whose circumstances may make them vulnerable

Good

Updated 18 January 2018