Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Albrighton Medical Practice on 5 January 2016. Overall the practice is rated as outstanding.

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.

• All opportunities for learning from internal and external incidents were maximised but not always as well documented as acted upon.

• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. The practice recognised the value of patient care over and above ensuring they achieved good Quality and Outcome Framework (QoF) results and they choose to maintain some former QoF requirements to ensure they captured all the quality aspects of the service they provided.

• The practice GP staff accessed the RAF base nearby to provide a GP service where required.

• Feedback from patients about their care was consistently positive.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they met patients’ needs.

• The practice welcomed young people and was a Department of Health (DoH) awarded ‘You’re Welcome’ practice. The practice provided young people with their own ‘You’re Welcome' brochure.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group. Examples included: arranging a home delivery service from chemists for house bound patients, changes to the arrangement of seating so chairs with arms were readily available for those needing them, and the provision of community transport links to help patients attend surgery.

• The practice had good facilities and was well equipped to treat patients and meet their needs. 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. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.

We saw several areas of outstanding practice including:

• The practice ensured that any children at risk from actual or potential abuse who re-located to another area were followed up by arranging a discussion with the new GP practice to share any known concerns.

• The practice provided support considered to be above and beyond that which was expected with regards to palliative care patients. Each patient had priority in terms of appointments, telephone contact or visits from their preferred GP. GPs gave out their own mobile telephone numbers to these patients and continued to visit them on days off, weekends and evenings. The practice held a register of 79 palliative care patients, most of whom were elderly.Each patient was discussed monthly at a dedicated multidisciplinary meeting with representatives from the district nurses, local hospice and all available doctors.

• The practice demonstrated a whole practice approach to significant event reporting and had a designated lead GP for significant events, who also presented any findings annually to the whole team. Events were risk rated to identify those with more serious implications for patient safety to prioritise them for action. Positive events were also recorded to ensure these could be celebrated and shared as good practice with the team.

However there were areas of practice where the provider should make improvements:

• Complete documentation such as noting the serial numbers and number of prescription sheets to ensure blank prescription pads are auditable.

• The practice should check that all the fire alarm call points work and investigate whether the smoke detectors and emergency lighting had been checked and maintained.

• At the end of the complaints process a letter from the practice should inform the complainant of the further steps available to them if they remain unhappy.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice