Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at John Hampden Surgery on 27 January 2016. The practice is rated as outstanding for the care and treatment of three population groups – families, children and young people, people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia). As a result of three outstanding population groups and outstanding caring and responsive domains, overall the practice is rated as outstanding.

Our key findings across all the areas we inspected were as follows:

• 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.

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.

• Risks to patients were assessed and well managed, this included plans to action areas for improvement from the recent Infection Control audit.

• Feedback from patients about their care was consistently and strongly positive. However, not all patients were aware of the extended hours and several commented on recent difficulties accessing appointments.

• Outcomes for patients who use services were consistently very good. Nationally reported Quality and Outcomes Framework (QOF) data, for 2014/15, showed the practice had performed excellently in obtaining almost all of the total points available to them for providing recommended care and treatment to patients.

• Staff were consistent in supporting patients to live healthier lives through a targeted and proactive approach to health promotion.
• We found there was good staff morale in the practice, with high levels of team spirit and motivation. There was a strong learning culture evident in the practice. This came across clearly through discussions with staff members and in the approach to adopting and championing new initiatives.

We saw several areas of outstanding practice including:

• In February 2015, the practice was successful in a bid to make the practice ‘dementia friendly’. The practice has identified dementia patients early, supported them to access good quality care, improve their quality of life and prolong independent living. There was a named dementia support nurse ensuring a personalised care plan for all dementia patients, all staff had additional training in recognising and supporting people with dementia, double appointments for dementia patients were routine and the practice environment was dementia friendly with appropriate signage and a ‘quiet space’.

• The practice had recognised that carer’s health often takes second best, or neglected and was offering designated clinics every Friday for carers. Of the 70 carers, 38 (54%) had attended a carers clinic and the remaining 32 had been contacted and an appointment scheduled providing support through community settings to enable patients to live independently for longer.

• The practice supported patients to live healthier lives through a targeted and proactive approach to health promotion and prevention of ill health. For example, there was a designated staff member who arranged and scheduled childhood immunisations. This was evident as immunisation rates were higher when compared to the CCG and national averages.

• In partnership with Bucks County Council, the practice was awarded a 'Safe Place' status. This scheme provides reassurance to vulnerable people, and to their families and carers, so that they have a means to alert someone of any potential risk or emergency if they are out alone. Having access to the practice as a place for safety within the village helps vulnerable people lead independent lives and feel safe. There was a Duty GP available should a vulnerable person accessing the practice as a ‘Safe Place’ require urgent care and treatment. Although only recently awarded the practice has supported a vulnerable patient recently seeking refuge at the practice whilst experiencing an episode of panic and confusion.

However, there was an area of practice where the provider needs to make improvements. Importantly the provider should:

• Review how patients can have appointments to see a male GP and have a male chaperone if wanted.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

We reviewed the information available to us about John Hampden Surgery on 14 May 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.