The practice is rated as good overall. The previous inspection report was published in June 2016 and the practice rated good overall and outstanding for caring.

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at Bildeston Health Centre on 6 February 2019. This was part of our planned inspection programme. 

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected

• information from our ongoing monitoring of data about services and

• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall. At this inspection we found:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness, compassion and respect and involved them in decisions about their care and treatment.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
• The practice is no longer rated as outstanding for caring. Initiatives that were previously regarded as innovative or unusual may no longer be so, because things have moved on in primary care and having now inspected all GP practices we have a better understanding of the baseline.

Whilst we found no breaches of regulations, the provider should:

• Improve the system for the oversight of training, to ensure it is effective and accurate.
• Improve the system for checking that evidence based practice is followed for prescribing.
• The practice should have a formal proactive check of the competency of staff employed in advanced clinical practice.
• Continue with plans to re-establish the Patient Participation Group.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bildeston Health Centre on 23 March 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 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.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• 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 provider was aware of and complied with the requirements of the Duty of Candour.

We saw areas of outstanding practice:

• The practice had developed their own template for care plans and health reviews and took active steps to ensure they discussed and recorded patients advance wishes for end of life where appropriate. The practice undertook regular audits of patients end of life outcomes and reported that in 2015 50% of those patients on end of life care pathways had died in their preferred place of death; an increase from 20% in 2010.
• The practice team ran a carers group which was set up in 2012. The practice held monthly meetings for carers at the practice where members of the team attended with carers and patients for afternoon tea and cake, support and advice and presentations by visiting speakers. For example the practice had facilitated presentations by Age UK, a holistic therapist who demonstrated head massage techniques and The Royal British Legion. These were well received by carers, the patients and their families with approximately 40 to 50 people in total with 15 - 20 attending the meetings each month. GPs told us this was a staff team effort, from the partners supporting and attending some meetings to the practice staff giving up their time to provide refreshments and lend a listening ear, and the practice domestic technicians setting up the rooms and clearing away at the end of the meetings.

The areas where the provider should make improvements are;

• Ensure patients with a learning disability receive an annual face to face review of their care plans.
• Ensure the practice is more proactive in recording all contacts with patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice