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Nine in 10 GP surgeries in England have been rated as good and outstanding by inspectors.

It means general practice is the highest performing sector in the NHS, according to the Care Quality Commission ratings, above hospitals, mental health and social care.

But inspectors did flag up safety concerns at one in seven practices.

The inspection regime has taken nearly three years to complete and involved more than 7,300 surgeries.

The safety concerns included problems with:

storing vaccines at the right temperature

filling in prescriptions quickly enough

having defibrillators that work properly

learning from mistakes

But some of these concerns were not considered serious enough to warrant the practice getting an inadequate or requires-improvement rating.

Prof Steve Field, the CQC's chief inspector of GPs, said the sector should be commended for its efforts given the pressures being faced by doctors.

Over the past three years there has been a 7% increase in the number of people registering with GP practices and reports that people are finding it more difficult to access a GP.

But Prof Field said he was impressed by what he found.

"The pressures on GPs are very real, but we have found many practices are already delivering care in new and innovative ways to benefit their patients and wider community."

This includes practices embracing digital technologies such as telecare and working proactively with other services, including district nurses, to provide services across large rural areas.

In fact, GPs in rural areas were more likely to get outstanding ratings than those in urban areas, some of which are struggling to recruit doctors.

'Soaring demand'

The report also showed a number of practices had improved following re-inspections of 1,400 of the worst performers.

Dr Richard Vautrey, of the British Medical Association, said: "These positive results are undoubtedly down to the hard work of GPs and practice staff, but many are in an environment where they are increasingly struggling to deliver effective care to their local communities.

"A recent BMA survey found a majority of GPs in England are considering temporarily closing their practice list to new patients because of the impact of soaring demand, stagnating budgets and widespread staff shortages."

Health Secretary Jeremy Hunt said the results were a "huge achievement".

But he acknowledged there was now a need to "expand the workforce so that these high levels of care can be sustained".

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