Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Deane Medical Centre on 18 December 2015. Overall the practice is rated as outstanding.

We found the practice to be outstanding the domains for providing safe, effective and well-led services. It was found to be good for providing safe and effective services.

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

• 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.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them. This included having a website where each page could be translated into many different languages.
• 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 (PPG).
• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand
• The practice had a clear vision which had quality and safety as its top priority. A business plan was in place, was monitored and regularly reviewed and discussed with all staff. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

We saw several areas of outstanding practice including:

• In addition to safeguarding training for adults and children staff had received training in how to recognise domestic violence and how to identify signs of female genital mutilation (FGM). Awareness training focussed on the diverse cultures of the patients of the practice.
• A non-English Speaking Patient (NESP) support worker worked from the practice. They were able to translate for patients but also worked with families and individuals to educate them in health matters and how the NHS worked. The practice had been proactive in organising the service as an innotive way of meeting the needs of their patient population.
• The GPs and practice nurses arranged meetings for other clinicians in the area. These were used to share good practice, collectively discuss serious untoward incidents and significant events, and take part in training sessions as part of their continuing professional development (CPD).
• Patients with a learning disability, mental health needs or Dementia were invited for an annual review of their physical and mental health needs. Dual appointments with the GP and nurse were arranged and the clinicians used a template to identify all health needs and issues. This decreased the number of appointments required for the patients. They also involved the patients’ carers where appropriate and consent had been given so convenient appointments that were less likely to be missed were arranged.
• The nurse ran a drop in centre for students at the university. Any student could attend, including patients of other practices. Where appropriate patients were signposted to the most appropriate service, and their healthcare needs could be met by the nurse if possible. There was evidence of mental health issues being identified during these drop in sessions.
• A GP telephoned a care home every Friday to see if they had any concerns that required attention before the weekend. The home provided feedback to us, stating that a GP visited at least once a week, had a walk around to see any patient who required attention, and involved patients in their care planning.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Deane Medical Centre on 18 December 2018 as part of our inspection programme. The practice was last inspected in 2014 when they received an Outstanding rating. We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and good for all population groups.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

We saw areas of outstanding practice:

• The GPs at this practice provided a responsive service to the vulnerable population group. They undertook regular education sessions on Saturday mornings to improve patients’ understanding of their long-term diseases and address concerns. The practice had identified language as one of the biggest barriers to good health outcomes and used various innovative methods of communication to overcome those barriers. They had identified an increase in the Somali community and used the local Mosque to in reach to that vulnerable population group. A specific bereavement sessional group was introduced to enable patients to support each other. They continued to explore barriers to poor compliance and improve health outcomes for patients.

The practice should:

• Assess the risk of non-wall-mounted sharps bins
• Consider lowering the threshold for significant incidents

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice