Stour Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Stour Surgery on Tuesday 25 October 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment. Staff had access to formularies and guidelines by incorporating them onto the patient computer system.

• Patients had access to the Parkinson’s disease specialist nurse who visited the practice.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Feedback from friends and family tests and national surveys was also positive.
• The practice held regular multi-disciplinary team (MDT) meetings to discuss vulnerable patients. In addition cluster group meetings were run by the SCOT (Stour Community Outreach Team) and SOS (Stour Outreach Sister) teams to discuss patients on these schemes.
• The practice had identified over 4% of patients who were carers and offered them social support and signposted them to other services.

• The practice encouraged its patients to attend national screening programmes for bowel and breast cancer screening.

• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• We looked at the friends and family patient feedback between July and September 2016. These showed that of the 300 patients who had responded, 286 would be extremely likely or likely to recommend the practice to others.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.

• Text reminders were used to remind patients of their appointment. Patients could use text messages to cancel appointments in an attempt to reduce any ‘did not attend-DNA’ appointments.

• The practice had good facilities and 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.
• The practice was a teaching practice for doctors who wanted to become GPs with good feedback from trainees and the local NHS health education team.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw two areas of outstanding practice:

• The practice employed a SCOT nurse and Stour Outreach Sister (SOS) who worked with vulnerable, mainly elderly patients or patients with long term conditions to reduce hospital admissions and improve their quality of life. This model of care was appreciated by local care homes and had been adopted locally and had contributed to a reduced number of emergency hospital admissions. For example, Stour surgery had the second lowest number of emergency admissions for the year and the lowest on a rate per 1000 patients across a rolling year, which saved the CCG just under £27,000. The data also showed a continual downward trend in emergency admissions.

• The practice had set up a befriending project called Christchurch angels. The scheme, involving volunteers initially aimed to improve the health and wellbeing of people who live in the locality and had won an award in 2013. The scheme was very successful and was now run by another agency elsewhere in the town but was still supported by the practice. Since the scheme started at the end of September 2013, Stour had referred 70 patients which was the highest source of referral the scheme had received.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice