Letter from the Chief Inspector of General Practice

This practice is rated as Good overall.

The key questions are rated as:

Are services safe? - Good

Are services effective? - Good

Are services caring? - Good

Are services responsive? - Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People - Good

People with long-term conditions - Good

Families, children and young people - Good

Working age people (including those recently retired and students - Good

People whose circumstances may make them vulnerable - Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Burnley Practice on 2 November 2017. We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether Burnley Practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• The practice proactively sought feedback from staff and patients, which it acted on.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• The practice used innovative and proactive methods to improve patient outcomes and worked with other local and national healthcare providers to share best practice.

We saw areas of outstanding practice:

• The practice used information technology systems to monitor and improve the quality of care. The electronic dashboard used across the provider group was a powerful tool for understanding the practice's comparative performance across a range of clinical indicators and had provided access to bespoke searches relevant to medicines management and effective care. This enabled the practice to readily identify when follow up tests and screening were due in the management of patients with long term conditions.
• The practice had offered GP services to 380 street homeless people or those in temporary or hostel accommodation in the London Borough of Brent. One of the GPs was offering weekly clinics in a local shelter home. A dedicated counsellor was employed by the practice who was acting as a regular link between the homeless patients, keyworkers at the hostel and the practice. The practice’ computer system would alert staff to all of the outstanding care needs of patients who visiting the practice. This helped clinicians provide more effective care for patients who preferred to attend the practice infrequently.
• The practice had used innovative and proactive methods to assure effective communication across the organisation. For example, the practice had initiated an online networking tool to share learning, information, ideas including social events and peer support. The provider was using this online tool to monitor the performance and utilising the resources, such as, managing the winter pressure or when the demand increased for appointments. The provider had sent the weekly and monthly staff bulletins to all staff members. This provided them with any information about the practice including clinical updates, staffing matters, training opportunities and any changes within the practice group. An interactive on-line messaging system, ‘message my GP’ was available for patients to direct non-urgent queries to a GP with a response turnaround of up to 48 hours.
• Staff had access to a learning and development portfolio featuring face-to-face and web-based training programs tailored for each staff role. For example, fortnightly web-based training for healthcare assistants; development support for practice nurses; a development programme for practice managers and pharmacists and a fortnightly consultant led learning program for clinicians.

The areas where the provider should make improvements are:

• Review the system in place to improve the management of blank prescription forms.
• Review the system in place to promote the benefits of breast cancer national screening in order to increase patient uptake.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice