Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at FMC Health Solutions Limited on 15 September 2015. Overall the practice is rated as good.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

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.

• 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.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet people’s needs.

• 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.
• The practice had a substance misuse and abuse worker to support alcohol reduction and could demonstrate this had a positive impact for patients using this service. Overall patient satisfaction was the best in the CCG
• Clinician staff to patient ratio was amongst the highest in the CCG

• Patient satisfaction ratings: Access, Quality, Patient Experience, amongst the highest in the CCG.

• Friends and Family Test scored 97% approval (July 2015)

• The practice obtained a top ten Flu vaccination rate in the CCG

• 65% of patients with three or more Long Term Conditions (LTCs) had a care plan

• The practice is accredited as ‘Safer Place’ a safe haven for vulnerable patients lost in the community

• Internet development included on-line video tutorials for patients on managing long term conditions and new medication compliance

We saw several areas of outstanding practice including:

• The practice had pioneered GP and advanced nurse practitioner (ANP) appointments at Pontefract General Infirmary to improve access for patients at weekends and to reduce the burden on the local accident and emergency department. During the period of the pilot the GP service saw 760 patients. These patients would otherwise have been managed by the A&E clinicians, so it reduced A&E’s workload.

• The practice had increased the flexibility of access to appointments and could demonstrate the impact of this by reduced use of the GP out of hours service and very positive patient survey results.

• The practice had reached out to the local community by approaching schools and had attended them to promote better health. If any underlying health issues were identified the patients (if they belonged to the practice) were offered an appointment at the practice and patients from other practices were advised to attend their own GP.

• The practice was involved with two national studies and a quality improvement programme to better manage patients with Diabetes with detailed action plans which target higher risk patients. One of the GPs recently had this work published by RCGP and the results were disseminated nationally.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice