Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Eastgate Medical Group on 14 & 15 March 2016. 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 reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they were able to get same day appointments however some patients told us it could be difficult to make appointments. GPs had ‘personal lists’ providing all patients with a named GP and continuity of care.
• 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.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw an area of outstanding practice.

The practice had identified that direct access referral for CT Scans of head, chest, abdomen and pelvis would improve the quality of referrals and reduce the need for patients to attend unnecessary hospital appointments. This was discussed with the hospital radiology department and it was agreed to run a small pilot scheme with three practices to allow them direct access referral. After six months feedback from the pilot was positive and it was agreed that all the practices in the area would be enrolled onto the community CT access scheme.

An audit showed that of the 72 practice patients who had been referred through the direct access scheme 18% had had an improved referral and 46% had had an unnecessary referral prevented.

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

Importantly the provider should:

• Ensure there is an audit trail of blank prescriptions forms.

• Ensure all staff are up to date with mandatory training.

• Implement a carers register.

• Ensure the practice has a written strategy and supporting business plan which outlines their vision and plans for the future.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice