Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Herstmonceux Integrative Health Centre on 29 September 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.
• There was a strong focus on providing integrative care (based on treating the whole person rather than just the illness and the symptoms with a combination of medical and social prescribing) and the practice used innovative and proactive methods to improve patient outcomes. For example, it worked closely with other organisations to provide a full range of NHS services as well as a number of different social prescribing and community based schemes including singing workshops and walking for health.
• Feedback from patients about their care was consistently positive. The practice scored above average in all areas of the national GP survey.
• The practice placed a strong emphasis on addressing the wider social and lifestyle and community aspects of their patient’s health and worked closely with other organisations and with the local community to do this. For example in conjunction with members of its patient participation group and members of the parish council it had established ‘Vitality Villages’ as a platform to promote recreational and well-being activities within the parish to the public, ensuring that all ages and genders were catered for.
• 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). For example, the practice provided Saturday morning appointments and a dedicated flu clinic on Saturdays for working patients in response to patient feedback.
• 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 to deliver high quality integrated care working in conjunction with its partners in the community and to empower patients in achieving their health goals 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.

• The health centre had been purpose built and designed to support

  the practice’s vision to provide a sense of calm and relaxation for both patients and staff alike. It had been built with the patient experience in mind, to maximise natural light and reduce the impact on the environment. Patients told us that the practice environment promoted a sense of well-being whenever they visited.

We saw several areas of outstanding practice:

• There was a strong emphasis on providing integrative care which combined safe, effective medical treatment with a range of social prescribing initiatives. This enabled the practice to address the wider social and lifestyle and community aspects of their patients’ health. The practice endeavoured to empower patients to achieve their health goals through a number of different social prescribing and community based schemes. This included the prescribing of books from its patient library, singing workshops, healthy walks and a monthly coffee morning for elderly, isolated patients. The practice was able to demonstrate improved patient outcomes as a result.
• Working with the community and other organisations was integral to the practice’s vision to provide integrated care. In conjunction with its PPG and the parish council it established a group called ‘Vitality Villages’ which promoted recreational activities within the parish to the public, ensuring that all ages and genders were catered for and to ensure those who felt vulnerable or lacked confidence were enabled to make connections. Vitality Villages held a number of regular events targeting particular patient groups including men, older people, families and children and those who were vulnerable or isolated. The practice was able to demonstrate increased uptake of community well-being activities and reduced social isolation as a result.

The areas where the provider should make improvement are:

• Ensure that blank prescription forms for use in printers are tracked in accordance with national guidance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice