Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Barrack Lane Medical Centre on 12 May 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management.
• The practice proactively sought feedback from staff and patients, which it acted on.
• The practice was aware of and complied with the requirements of the Duty of Candour.

We saw areas of outstanding practice:

• One GP and the practice manager had set up and continued to fund a website which provided a service to other GPs and junior doctors, making information more accessible to GPs, GP registrars and trainers. The website included a wide variety of guidance and support, for example it provided full guidance for the curriculum for the Royal College of General Practitioners, a resource designed to improve both quality and safety for patients. In addition to this, there was guidance on how to undertake Educational Supervision Reports (a workplace based assessment which builds up a picture of an individual’s performance and provides feedback on overall progress highlighting areas where more focused training may be required).
• The practice facilitated and participated in a specific project co-produced with the local Clinical Commissioning Group (CCG), NHS England, Health Outreach NHS and Barrack Lane Surgery to provide a full medical, psychological and social assessment for non-English speaking patients who were new to the NHS.
• The practice had developed a motivation tool for vulnerable patients who were of low mood or depressed. Where a patient was identified as requiring extra support the practice provided extended appointments to encourage recovery without the use of drugs and anti-depressants. Patients were encouraged to complete a goals list tool, developed by the practice to inspire and motivate the patient before their next review. These goals included personal, financial and career goals and encouraged patients to visualise their aims using all their senses. We were told this was a simple but powerful way to inspire patients to recover.

The areas where the provider should make improvement are:

• Ensure patients waiting for their appointments in all areas of the practice can be clearly seen by reception staff to ensure patients whose health might deteriorate can be seen by staff.
• Continue to develop methods used to proactively identify carers.
• Ensure patients with a learning disability are encouraged to attend for a review of their care plans.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice