Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Chatsworth Road Medical Centre on 21 June 2016. Overall the practice is rated as outstanding.

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

• There was a genuinely open culture in which all safety concerns were highly valued and seen as integral to learning and improvement. Opportunities for learning from internal and external incidents were communicated widely with multi-disciplinary colleagues and external agencies.

• Robust systems were in place to ensure risks to patients were assessed and well managed. This included medicines management, recruitment and planning for emergencies.

• Staff took a holistic approach to assessing, planning and delivering care and treatment to patients in line with current evidence based guidance.

• All staff were actively engaged in clinical and internal audits to monitor and improve the care for patients.

• Published data showed patient outcomes were at or above average compared to the local and national averages.

• Regular multi-disciplinary team meetings took place to ensure patients with complex health needs were supported to receive coordinated care.

• All sources of information we reviewed including feedback from patients, carers and stakeholders was continually positive about the caring nature of staff. Positive examples were given by patients to demonstrate that staff had gone the extra mile to support them when needed and the care they had received exceeded their expectations.

• The practice provided excellent access (telephone and appointments) for patients to receive medical care and this was strongly reflected in patient feedback and survey results. In addition, usage of secondary services was below the local averages.

• Patients said they found it easy to make an appointment with a named GP and 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.

• The practice actively reviewed complaints and made improvements as a result.

• The practice had a clear vision which had quality and safety as its top priority. The action plan to deliver this vision was reviewed and discussed with staff.

• 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. This included patient education facilitated by the patient participation group.

We saw several areas of outstanding practice including the following:

• A team approach had been adopted to create an open and transparent environment for staff to raise significant events, however minor or significant, with the resulting impact of significant events increasingly being reported. Staff referred to significant events as learning opportunities to share (LOTS) which reflected the shared ethos within the practice. LOTS were also discussed during fortnightly multi-disciplinary team meetings and outcomes were shared with external agencies if needed, to ensure shared learning and improvement.

• Patient feedback was overwhelmingly positive about the way staff treated people and patients confirmed they had consistently received an excellent and compassionate service. This was corroborated by stakeholder feedback, friends and family test results and a wide range of internal and external survey results.

• The community dermatology clinic was accessed by patients registered with other GP practices within North Derbyshire. The service had been in operation for 18 months and was led by two GPs with special interest in dermatology; in collaboration with three other GPs and consultant. Diagnostic and treatment services were offered over two sessions a week and 484 patients had accessed the service as at 31 May 2016. Records reviewed showed this had promoted positive outcomes for patients and staff. For example:

• The operation of the service had reduced the treatment waiting times at the local hospital by 50%.

• 50% of patients who had received treatment were discharged after their initial appointment and the onward referral rate to secondary care was 12%.

• An overall recovery rate of 95% was achieved.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice