Letter from the Chief Inspector of General Practice

We inspected this service on 12 January 2015 as part of our new comprehensive inspection programme.

The overall rating for this practice is outstanding. We found the practice to be outstanding in the effective, responsive and well led domains. We found the practice to be good in the safe and caring domains. We found the practice provided outstanding care to people with long term conditions.

The performance that led to the ratings of outstanding in effective, responsive and well-led services apply to everyone using the practice. The achievement of these ratings meant that the practice also provided outstanding services to all population groups including older people, families, children and young people, working age people, people whose circumstances may make them vulnerable and people experiencing poor mental health.

Our key findings were as follows:

• Patients were kept safe because there were arrangements in place for staff to report and learn from key safety risks. The practice had a system in place for reporting, recording and monitoring significant events over time.
• Patients felt that they were treated with compassion, dignity and respect. The results of local and national patient opinion surveys were highly positive.
• Practice staff were keen to share learning and provided numerous opportunities for medical students to develop under their guidance.
• Patients told us the practice had a good range of appointments available that suited their needs and it was easy to make an appointment.

We saw several areas of outstanding practice including:

• The quality and range of care provided was high. The practice offered a comprehensive range of services in house. Patients who required diagnostic tests for skin conditions, assessment of cardiovascular (heart and blood vessel) function received them at the practice. This resulted in lower referral rates and waiting times for patients. The practice had lower than local and national rates for emergency admissions and contact with accident and emergency departments and out-of-hours services. Patients told us that the practice offered the services and continuity they wanted and this was reflected in higher than average patient survey results.

• The practice was inclusive for all. The practice cared for a number of patients who had previously displayed challenging behaviour and had developed positive relationships with them to address their behaviour. Also staff and students who had experienced difficulty were given high levels of support and had achieved high outcomes. The high levels of engagement and support provided by staff was evident throughout our inspection.
• Leadership at the practice was reflective, strong and decisive. Although already achieving high outcomes in a number of areas, the practice team wished to improve their services and the experience of patients.

However, there were also an area of practice where the provider needs to make improvements.

The provider should:

Ensure that the system for monitoring and providing medicines for patients who receive anti-coagulation therapy and are housebound is robust and understood by all staff involved in their care.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice