Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bramcote Surgery on 8 November 2016. Overall the practice is rated as outstanding.

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

• There was an open and transparent approach to safety within the practice. Effective systems were in place to report, record and learn from significant events. Risks to patients were assessed and well managed.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.

• Training was provided for staff which equipped them with the skills, knowledge and experience to deliver effective care and treatment.

• Outcomes for people who use services were consistently better than expected when compared to other similar services. Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were mostly above average compared to the national average.

• Feedback from patients about their care was consistently positive and above local and national averages. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• Patients told us they were able to get an appointment with a GP when they needed one, with urgent appointments available on the same day.

• The practice was responsive to the needs of their local population, and not just their registered patients. This enabled services to be delivered closer to patient’s homes. For example, a GP provided a vasectomy service and long acting reversible contraception (LARC) services for all patients within their CCG and outside of their CCG. Access to a community ultrasound clinic and consultant gynaecologist clinic hosted by the practice were available to people outside of the practice.

• Improvements were made to the quality of care as a result of complaints and concerns and learning from complaints was shared with staff and stakeholders.

• 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.

We saw a number of areas of outstanding practice including:

• There was evidence of a highly engaged patient participation group (PPG) who actively participated in a number of initiatives to enrich the lives of patients. They engaged with the local council and voluntary support groups to support the health and wellbeing of elderly patients.

• The practice was committed to supporting patients identified as having caring responsibilities. A carers drop-in clinic was offered every three months at the practice in cooperation with local carers organisations and provided support, guidance and advice for patients who were responsible for others. This included specialist support for young people who were carers.

• The practice demonstrated high levels of access compared to other practices in the local area. 98% of patients said they found it easy to get through to the surgery by phone, which was consistent with CCG data which showed that telephone calls were answered within 25 seconds.

• Patients were involved in decisions about their care and sought to keep patients informed about self-care. The practice developed in-house checklists to assist with clinical assessments, which were completed by patients prior to appointments. The checklists had been shared with local practices including a practice outside of their CCG, and implemented as examples of good practice.

• Staff, teams and services were committed to working collaboratively. People who have complex needs were supported to receive coordinated care and there are innovative and efficient ways to deliver more joined-up care to people who use services. The leadership, governance and culture were used to drive and improve the delivery of high quality person-centred care. Staff were motivated to use their initiative to take on roles such as the carers champion to benefit people using the service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice