Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Forest Hall Medical Group on 1 December 2015. Overall the practice is rated as good.

Our key findings were as follows:

• 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.
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
• 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.
• Patients said they were able to get an appointment with a GP when they needed one, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure in place and staff felt supported by management. The practice proactively sought feedback from staff and patients, which they acted on.

• Staff throughout the practice worked well together as a team.

• Staff had received training appropriate to their roles.

We saw several areas of outstanding practice including:

• An analysis tool, Reporting Analysis and Intelligence Delivering Results (RAIDR) was used, which enabled the practice to look at trends and compare performance with other practices. The latest report showed the practice was one of only two across the whole clinical commissioning group (CCG) area to achieve all of the ‘higher level indicators’ (for example, in relation to hospital admission rates and accident and emergency attendances).

• Staff were proactive in carrying out clinical audits to help improve patient outcomes. A significant number of audits had been carried out in the past year (14) and one of the GP partners had a dedicated weekly clinical session set aside specifically for audit work. All of the clinical audits we looked at were relevant, well designed, detailed and showed learning points and evidence of changes to practice. We saw these were clearly linked to areas where staff had reviewed the practice’s performance and judged that improvements could be made.

• A review of the uptake of the pneumonia vaccine showed that numbers had decreased over the past few years. A proactive campaign to contact patients was undertaken. This resulted in an increase from around 50 patients receiving the vaccine in 2013 to over 600 in 2014.

• The practice had written to high risk patients to encourage them to attend for health checks. Data showed the practice was the best performer across the CCG in relation to health checks, with over 20% of eligible patients receiving a check, compared to an average of around 9%.

• Patient privacy was given a high priority within the practice. There was a ‘patient station’ screened off from the main waiting room, this allowed patients to complete forms and collect specimen packs in a private area. Staff had designed forms for patients to complete to give to the receptionist if they did not wish to discuss their condition or requirement.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice