Archived: Lantern Surgery

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of Lantern Surgery on 18 November 2014. We visited the practice location at 3 Station Approach, Hinchley Wood, Esher, Surrey, KT10 0SP.We have rated the practice as requires improvement. Specifically, we found the practice to require improvement for providing safe, effective and well led services. The concerns which led to these ratings apply to everyone using the practice, therefore the different population groups are also rated as requires improvement. The practice was good for providing a caring and responsive service.

The inspection team spoke with staff and patients and reviewed policies and procedures implemented throughout the practice. The practice was responsive to the needs of the local population and engaged effectively with other services.

Our key findings were as follows:

• There was a range of appointments to suit most patients’ needs. Patients reported good access to the practice and a named GP or GP of choice, with urgent appointments available the same day.
• The practice engaged effectively with other services to ensure continuity of care for patients.
• Patient feedback showed that patients felt they were involved in making decisions about their care and were treated with kindness and respect.
• Staff told us there was an open culture within the practice and they felt well supported in their roles.
• Staff had not always received training in mandatory areas.
• Risk assessment and monitoring processes were not always in place to ensure the safety of patients and staff.
• Staff did not always have access to clear written guidance to support them in carrying out their role.

The areas where the provider must make improvements are:

• Ensure all staff are supported by means of appraisals and personal development plans.
• Ensure that all staff are trained in safeguarding of children and vulnerable adults and infection control processes.
• Ensure all staff have appropriate policies, procedures and guidance to carry out their role. This includes providing staff with policies for safeguarding vulnerable adults and infection control processes.
• Ensure recruitment processes include all required pre-employment checks in order to minimise the risks to the health, safety and welfare of patients.
• Ensure risk assessment and monitoring processes effectively identify, assess and manage risks relating to the health, safety and welfare of patients and staff, including fire safety, the risk of exposure to legionella bacteria and to support decisions relating to which staff roles require criminal records checks.

In addition the provider should:

• Establish a process to ensure more formal sharing of information and encourage continuous learning and improvement of all staff.
• Ensure adequate arrangements to cover staff absence in order to meet the needs of all patients, including the support and review of patients with long term conditions.
• Ensure appropriate consent is recorded from patients undergoing minor interventions such as joint injections.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice