Letter from the Chief Inspector of General Practice
Our key findings across all the areas we inspected were as follows:
• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Opportunities for learning from internal and external incidents were acted on.
• Risks to patients were assessed and well managed. However, the practice was not operating with its full complement of clinical staff which impacted on patient access to appointments and responsiveness of the practice. Recruitment of a pharmacist for the practice had been agreed but this process had not started. The practice was trying to fill a vacancy for a nurse. Staff interviewed said patient access was the main challenge for the practice.
• The practice used innovative and proactive methods to improve patient outcomes, for example, through its use of CCG sponsored services and health promotion.
• There was a system in place to undertake audits with a focus on improving patient care. The practice identified areas for improvement and monitored this over time to ensure required improvements were achieved and sustained, for example in the area of antibiotic prescribing.
• Patients said they were treated with compassion, dignity and respect. Information was provided to help patients understand the care available to them.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they met people’s needs.
• The practice invited suggestions for improvements and made some changes to the way it delivered services as a consequence of feedback from patients and from the Patient Participation Group (PPG).
• The practice was well equipped to treat patients. Information about how to complain was available and easy to understand.
• The practice had a clear vision which had quality and safety as its top priority. There was a clear leadership structure and staff felt supported by management.
There were also areas where the provider could make improvements. The provider should:
• Make checks on the drainage system from the practice premises to ensure that no remedial works are required.
• Ensure sufficient numbers of suitably qualified staff are deployed to meet the needs of patients.
We saw some areas of outstanding practice relating to families, children and young people.
The practice utilised community based services in innovative ways to help patients take ownership of their health and wellbeing. For example, work with a Health Engagement Officer, who acted as a link between local authority social services departments and the practice, had helped and supported numerous patients.
• Patients experiencing depression and isolation were helped to address triggers or causes of these problems, increasing their levels of confidence, in for example, parenting skills.
• We saw examples of this work which had a more far reaching impact, for example, in addressing low level anti-social behaviour of younger patients, in picking up previously undetected safeguarding issues such as teenage self-harm and increasing attendance of older children at school.
• Engagement with the local area Wellbeing officer had been used to provide a community run garden at the practice. More recently, this garden was used to allow younger children to plant and grow vegetables, providing a source of education that linked to health.
Professor Steve Field
CBE FRCP FFPH FRCGP
Chief Inspector of General Practice