Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cleobury Mortimer Medical Centre on 14 April 2016. Overall the practice is rated as good and rated outstanding in providing services for patients with long-term conditions.

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.
• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• 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.

• The practice had a clear vision on working in partnership for better health and wellbeing which underpinned commitment to good patient care and safety. Patient feedback and survey data, secondary care data and information from organisations such as the care coordinator and compassionate community (Co Co) staff member evidenced the effectiveness of this approach. (The Co Co initiative is not run by any one organisation but the community itself with the support of a hospice which provided training and ongoing guidance for volunteers. The scheme involves working with a number of local communities and medical practices).

• Feedback from patients about their care was consistently positive. The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group.

• The practice nurse with a specialism in diabetes also provided home visits to housebound patients, and the practice provided the diabetes medicine, insulin, and initiation treatment in-house.

• The practice used innovative and proactive methods to improve patient outcomes and worked with other local providers to share best practice. For example, glucose levels were checked for patients who had an NHS health check or review of long term conditions. Further investigations took place if glucose levels were elevated. Patients who were identified as in the pre-diabetic range were given lifestyle advice and monitored annually.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice actively reviewed complaints and how they are managed and responded to, and made improvements as a result.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.
• Patients said they found it easy to make an appointment, patients with a named GP or preferred to see a specific GP saw them within a reasonable period of time, there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities within a modern building and was well equipped to treat patients and meet their needs.

We saw an area of outstanding practice:

One of the GP partners provided an in house service for rheumatology patients registered at the practice. They provided a full range of joint injections and monitoring of medication, decreasing the need for hospital appointments. This prevented unnecessary travel for patients who may ordinarily travel to Kidderminster or Shropshire for investigations, treatment and consultations.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice