Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cranbrook Medical Centre on 11 May 2017. 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 recording, reporting and learning from serious significant events. Lessons were shared across the organisation and with other practices within the organisation. The process for managing near misses or minor events was under review.

• The practice had clearly defined and embedded local and organisational systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• An extensive range of clinical templates were used by clinical staff to ensure patients received evidence based practice and had all health checks and reviews performed.

• There was positive feedback from the Friends and Family Test and patients told us they were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.

• 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 majority of patients we spoke with said they found it easy to make an appointment with a 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.
• There was a clear leadership structure and staff felt supported by management and the organisation.
• The practice proactively sought feedback from staff and patients, which it acted on. For example, in response to feedback changes had been made to the appointment system.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

We saw one area of outstanding practice:

There was a higher than average number of children and babies at the practice and staff had a proactive approach to understanding and caring for the needs of those patients. The GPs and nurses all had experience, skills and additional training in the care of paediatric patients. Staff were also consistent in supporting people to live healthier lives through a targeted and proactive approach to health promotion and prevention of ill-health. For example developing an information leaflet and providing an app giving advice, support and guidance for common childhood illnesses including sepsis giving patients greater control and information of when to seek advice.

The areas where the provider should make improvement are:

• Ensure all prescribers at the practice are aware of the systems and processes used in the management of high risk medicines.

• Review processes, systems and records both at practice level and organisational level to ensure comprehensive records and audit trails are in place to reflect the actions and decision making process fully for minor events and near misses.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice