Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Fernley Medical Centre on 13 April 2016. Overall the practice is rated as good.

Our key findings were as follows:

• 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 carried out an annual significant event audit to ensure learning from significant events.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. The GPs were leads in different areas and had weekly meetings to discuss concerns and share learning.

• There was a clear leadership structure and staff felt supported by the GPs and the practice manager. The practice proactively sought feedback from staff and patients which it acted on. There was a very pro-active Patient Participation Group (PPG) of which we met with eight members during the inspection.

• The practice was aware of and complied with the requirements of the duty of candour.

• Risks to patients were assessed and well managed.

• Patients described staff as caring, understanding and helpful. Patients commented that they were treated them with dignity and respect

• 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 found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.

• The practice was able to refer patients to a community clinic to get expert specialist advice in a number of specialities without needing to refer to secondary care. This meant that there were shorter waiting times for appointments and it was more convenient for patients as the facilities were local.

• In the last year the practice had obtained second opinions in this clinic for:

  • 183 dermatology (skin) referrals

  • 29 opthalmology (eye) referrals

  • 472 ultrasound scan referrals

• Appointments were available to practice patients as well as patients from six other practices in the locality. Unregistered patients signed a consent form which allowed the practice to access their medical records. This included enhanced sexual health services for patients of other practices. This meant that patients would not have to wait for eight week referrals to secondary care.

• Staff had also attended education sessions in female genital mutilation (FGM) and Domestic Violence Training (IRIS).

• The CCG funded a winter pressures scheme to help with patient expectations and demands. This commenced on 15 December 2015 for an initial duration of three months. Through this initiative they were providing same day appointments between 2pm-6pm every weekday and 10am to 4pm on weekends. This scheme had been extended by the CCG and allowed the practice to take pressure away from A&E departments.

• The practice was one of the few GP practices providing enhanced sexual health services to registered and unregistered patients.

The provider should:

• Implement a programme of continuous audit to complete audit cycles and gauge the effectiveness of the improvements it makes.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice