Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Kirkby Community Primary Care Centre on 7 September 2017. This service was placed into special measures in September 2015. This related to a previous provider that no longer operates this service. This inspection took place following the implementation of a new provider in October 2016 and found significant improvements had been made to the quality of care provided. I am taking this service out of special measures, which reflects the significant improvements in clinical safety, quality assurance and leadership.

Overall the practice is now rated as good.

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

• 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.
• Clinical pharmacists had implemented medicine audits and worked with discharging hospital clinicians to improve patient safety and long-term prescription monitoring.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, 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 provider had established clinical and non-clinical support processes for staff.
• The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw areas of outstanding practice:

• There was evidence of sustained and wide-ranging improvements in leadership, governance and patient safety since we last inspected the practice under a previous provider. Improvements had been made at all levels of the practice and there were demonstrable improvements for patients, which had resulted in some patients returning after having left to register with an alternative practice.
• There was significant focus on multidisciplinary care to meet the needs of vulnerable people and those with complex needs. This included an in-house ‘pathways’ patient advisor and weekly scheduled clinics for those with needs relating to drug and alcohol use.
• The practice performed significantly better than the CCG in the pre-diabetes education programme, uptake of the improving access to psychological therapies programme and the completion of health checks.

The areas where the provider should make improvement are:

• The provider should continue to work towards establishing a permanent GP team to ensure consistency of available appointments and clinical governance.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice