Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Derby Family Medical Centre on 02 December 2014. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well led services. It was also good for providing services to all population groups we inspected.

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

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Most patients said they found it easy to make an appointment and urgent appointments were available the same day.
• Information about services and how to complain was available and easy to understand.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and the Patient Participation Group (PPG).
• 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. The practice proactively sought feedback from staff and patients, which it acted on.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Continue to take steps to try and improve the process for making appointments and investigate ways to improve telephone access to ensure patients can access appointments when needed.
• Strengthen the system for recording and analysing significant events to ensure lessons are identified and learned to prevent events reoccurring.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

All patients said they were satisfied with the service provided. One patient said “It’s a really good practice.” Another told us “They offer a good service.” We saw patients were spoken with in a professional and friendly manner by staff, both on the telephone and face to face. All patients said they could get an appointment when they needed one, either the same day or booking in advance. Patients told us they felt involved in their care and were able to ask questions. They said treatment options were discussed with them, and results of tests were fully explained. The patient population at the practice was diverse, and English was not the first language for a large number of patients. Patients were supported by interpreters on site or through the telephone language line.

Staff had received training in safeguarding children and vulnerable adults, and were aware of the appropriate agencies to refer safeguarding concerns to that ensured patients were protected from harm.

The provider had systems in place to reduce the risk and spread of infection. The premises were clean and tidy and patients and staff had good access to hand washing facilities and antibacterial gels.

The provider had systems in place for monitoring the quality of service provision. There was an established system for regularly obtaining opinions from patients about the standards of the services they received. This meant that on-going improvements could be made by the practice staff.

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection 02/12/2014 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Requires improvement

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 inspection at Derby Family Medical Centre on 15 December 2017 as part of our inspection programme.

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.

• The practice used information about care and treatment to make improvements. For example, they initiated a management plan where patients with diabetes whose condition was poorly controlled were invited for monthly reviews, resulting in improved engagement and outcomes for the patients.

• Staff involved and treated patients with compassion, kindness, dignity and respect. Most of the staff were bi-lingual and spoke the same languages as the majority of the patient population. An interpreter was available on site five days a week to provide translation services for Urdu and Punjabi speaking patients.

• The practice understood the needs of its population and tailored services in response to those needs. They worked closely with other practices in their area to provide a local hub pilot scheme providing pre-bookable appointments in the evenings and at weekends seven days a week.

• However, since our last inspection, patient survey results showed a continued reduction in patient satisfaction in relation to access to appointments. Plans to improve telephone access and changes made were yet to be embedded and patient satisfaction had not yet improved.

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Consider security arrangements for prescription stationery to ensure it is securely stored.

• Continue to monitor and ensure improvement to national GP patient survey results particularly in relation to access to appointments , telephone access and patient experience.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice