Letter from the Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at John Smith Medical Centre on 7 May 2015. The overall rating for the practice was good, with a requires improvement rating for the effective key question. The full comprehensive report can be found by selecting the ‘all reports’ link for John Smith Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 21 December 2016 to confirm the practice had carried out their plan to address the areas we identified as requiring improvement in our previous inspection. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is still rated as good.

Our key findings were as follows:

• The practice had implemented a system to track clinical letters and results, however they were received, to ensure they were acted upon.
• The practice demonstrated learning from significant events including a process to learn from other practices in the provider’s cluster group.
• Staff demonstrated understanding of the local challenges in encouraging parents to agree to immunisations for their children and had put initiatives in place to address this.
• Clinical audits were embedded in the practice’s quality assurance and clinical improvement systems.
• A patient engagement specialist had visited the practice and a series of patient drop-in sessions had been arranged to encourage patients and their relatives to contribute to the development of the practice.

All of the areas for improvement had been addressed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at John Smith Medical Centre on 7 May 2015. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• 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 found it easy to make an appointment with a named GP 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 and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

We saw one area of outstanding practice:

• The practice ran a transitional health service to provide primary care to patients in Barking and Dagenham (and parts of Redbridge) who were in particularly vulnerable circumstances, for example asylum seekers who had been refused leave to remain and had exhausted their rights to appeal. The practice was able to demonstrate a multi-disciplinary approach, recognising that patients frequently presented with multiple and specialised needs. The practice was committed to identifying ways they could help patients and had developed a wide signposting and referral network including charities and voluntary groups. In one case, the practice staff had proactively identified a need and had sourced specialist equipment for a young child. We saw a letter from the family thanking the staff and describing the impact of their intervention as life-changing.

However there were also areas of practice where the provider needs to make improvements. The practice should:

• Implement a system to track clinical letters and results received by post to ensure that all actions are completed.
• Share learning from significant events across the team and take opportunities to learn from significant events in other surgeries in the Chilvers and McCrea Limited group to minimise the risk of reoccurrence.

• Aim to improve practice child immunisation rates.
• Ensure that completed clinical audit cycles are carried out to ensure that identified improvements are sustained.
• Continue to try and broaden patient participation in service development, for example through the patient participation group.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice