The area where the provider

should

make improvements are:

• Review and improve the provision of access to a female GP for patients that may prefer this.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall, but is rated as requires improvement for providing caring services. (The previous inspection was carried out on 4 November 2014 and the practice was rated as Good.)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Requires improvement

Are services responsive? – Good

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 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 comprehensive inspection at Little Horton Lane Medical Centre - Mall on 13 December 2017 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems and protocols to review and manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• There was an embedded system in place for actioning and cascading medicine safety alerts.
• The partners in the practice routinely reviewed the effectiveness and appropriateness of the care they provided by a process of peer review and keeping themselves up to date with best practice. This ensured care and treatment was delivered according to evidence- based guidelines.
• We saw that staff treated patients with kindness. However, results from the July 2017 annual national GP patient survey found that patients did not feel they were always treated with compassion, dignity and respect.
• Patient satisfaction with access to appointments was comparable to the local clinical commissioning group (CCG) averages but below national averages. The practice were aware of this and had conducted their own survey between April and July of 2017. We saw that urgent appointments with GPs were available on the day of inspection.
• The practice had identified that some pregnant women were not referring themselves as expected to midwifery services following their initial confirmation of pregnancy. Therefore, all pregnant women were proactively referred directly to midwifery services by the clinicians at the practice.
• The practice had commenced a review of the immunisation status of the staff team; in line with the guidance ‘Immunisation against infectious disease’ (‘The Green Book’ updated 2014.) However, this had not been fully completed on the day of inspection.
• The practice had approached a local branch of a national children’s charity and from January 2018 had firm plans in place to begin working with them. The practice planned to hold workshops and talks and hoped to engage young people with the practice and in the patient participation group (PPG).
• We saw that the practice struggled to maintain a functioning Patient Participation Group (PPG) but were taking all necessary steps to support this.
• The practice were keen to engage with the wider community. They held charity events and regularly collected food items for local food banks.

We saw one area of outstanding practice:

• The practice offered language classes to newly registered eastern European patients. During new patient health checks for this population, additional time was also allocated to enable the clinician to explain the NHS health care system and manage patient expectations.

The areas where the provider should make improvements are:

• Continue to review and act upon the results of patient satisfaction surveys in order to meet the needs of their patient population in the future.
• Continue to review access to the service and assure themselves that they are able to provide an appropriate number of appointments to meet patients’ needs.

• Continue to improve the identification of carers to enable this group of patients to access the care and support they require.
• The provider should continue to review and document the immunisation status of the staff team.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection visit on 4 November 2014 and the overall rating for the practice was good. The inspection team found after analysing all of the evidence that the practice was safe, effective, caring, responsive and well led.

Our key findings were as follows:

• The practice provided good, safe, responsive and effective care for all population groups in the area it serves.

• All areas of the practice were visibly clean.

• Where incidents had been identified relating to safety, staff had been made aware of the outcome and action taken where appropriate, to keep patients and staff safe.

• Patients received care according to professional best practice clinical guidelines. The practice had regular information updates, which informed staff about new guidance to ensure they were up to date with best practice.

• The service was responsive and ensured patients received accessible, individual care, whilst respecting their needs and wishes.
• The service was well led and there were positive working relationships between staff and other healthcare professionals involved in the delivery of service.

We saw several areas of outstanding practice these included:

• The practice is providing rapid and quality care provision, for ultra sound scanning and anticoagulation clinics. This service is called ‘at the patients’ doorstep’ and is available for other GP practices patients.
• The practice is working with the hospital to screen patients for Hepatitis B & C.
• The practice is opening on Saturday mornings during the winter months to reduce hospital pressures.
• There is a named staff lead who actively works with the PPG to improve patient care.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice