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Inspection carried out on 19/12/2019

During an inspection looking at part of the service

We carried out an inspection of this service due to the length of time since the last inspection. Following our review of the information available to us, including information provided by the practice, we focused our inspection on the following key questions:

  • Are services at this location effective?
  • Are services at this location well-led?

Because of the assurance received from our review of information we carried forward the ratings for the following key questions:

  • Are services at this location safe?
  • Are services at this location caring?
  • Are services at this location responsive?

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.

We have rated this practice as good overall and good for all population groups.

We found that:

  • Patients received effective care and treatment that met their needs.
  • The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

Whilst we found no breaches of regulations, the provider should:

  • Continue to monitor and improve medicines prescribing rates.
  • Review and improve uptake rates for the childhood immunisation programme and the cervical screening programme in line with national targets.
  • Review and improve the system for seeking and recording patient consent to care and treatment in line with national guidelines.

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

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Inspection carried out on 2 February 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Burnhams Surgery on 2 February 2014. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing caring,  responsive, well led, safe, and effective  services. The practice was also good for providing services for older people, people with long term conditions, families, children and young people, working age people (including those recently retired and students), people who circumstances may make them vulnerable, and people experiencing poor mental health.

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, with the exception of those relating to recruitment checks.

• 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 said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• Information about services and how to complain was available and easy to understand.

• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with appointments available the same day.

• 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 had a clear vision which had quality and safety as its top priority. A business plan was in place which was monitored and regularly reviewed and discussed with all staff. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

However, there was one area of practice where the provider needs to make improvements.

Importantly, the provider should:

Ensure that all clinical staff receive training in the use of the practice information system in order to support robust QOF data production.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice