Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Frances Street Medical Centre on 6 April 2016. Overall the practice is rated as outstanding.

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.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, the practice had liaised with the local bail hostel whereby residents were supported to access health care at the practice within a safe environment.
• Feedback from patients about their care was consistently positive.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. For example, t

  he practice employed a pharmacist who reviewed patients' medications, provided advice and support to patients and staff and also promoted medicines optimisation.

• The practice had identified the current premises were adequate and recognised they had used all of the available space. They were reviewing their existing accommodation and planning for future requirements. It was equipped to treat patients and meet their needs.  
• The practice actively reviewed complaints and how they are managed and responded to, and made improvements as a result.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.

• The practice had strong and visible clinical and managerial leadership and governance arrangements.

We saw several areas of outstanding practice including:

• The practice referred to the nurse who reviewed patient's in their own home as the  'iNurse'. They visited those patients unable to get to the surgery at home and performed joint consultations with GPs at the practice using video chat technology. This enabled the patient to see the GP and the GP to see the patient. We were told how this was particularly useful reviewing patient's with conditions that required visual assessment. For example, those with skin rashes.

• The practice had liaised with the local bail hostel whereby residents were supported to access health care at the practice within a safe environment.
• The practice employed a clinical pharmacist who supported staff at the practice through review of medicines prescribed, promoting best practice and providing advice for prescribing.  Patients were also able to book appointments with the clinical pharmacist for advice and support how to take their medicines and all patients taking multiple medicines were regularly reviewed and on the day following discharge from hospital.

• The patient participation group liaised with staff to schedule regular

  a programme of patient engagement events where practice staff and external speakers facilitated educational events for patients and people from the local community. Each year the PPG would meet and arrange the programme of events for the forthcoming year. Topics included living with alzhiemer's, an introduction to yoga, living with diabetes, bowel cancer screening, dementia primary care liaison nurse, overview of the wellbeing centre, services for patients who fall and minor illness advice from the local chemist. Patients told us they enjoyed the sessions and found them very informative and people travelled from other areas to attend.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice