Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Litchdon Medical practice on 7 July 2015.

Overall the practice is rated as outstanding.

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

• There was a strong commitment to providing co-ordinated, responsive and compassionate care for patients, particularly people with mental health needs.
• Urgent appointments were available the same day but not necessarily with a GP of the patient’s choice.
• The practice had good facilities including disabled access and recognised there were areas of the building which could be improved in consultation with disabled patients.
• Information about services and how to complain was available. The practice actively sought patient views about improvements that could be made to the service and worked with the patient participation group (PPG) to do this.
• The practice proactively sought to educate their patients to manage their medical conditions and improve their lifestyles. Additional in house services were available and delivered by staff with advanced qualifications, skills and experience.
• There were systems in place to reduce risks to patient safety for example, infection control procedures.
• Patients’ needs were assessed and care was planned and delivered following current practice guidance. Staff had received training appropriate to their roles.
• The practice used audits and had shared information from one of their audits with other practices to promote better patient outcomes.

We saw areas of outstanding practice:

• The practice had a strong vision which had quality and effective care and treatment as its top priority. High standards were promoted and delivered by all practice staff with evidence of clear communication across all roles and with external agencies.

• All staff were actively engaged in activities to monitor and improve quality and health outcomes for people. The practice was involved in a national pilot to provide education about healthy living to patients identified at risk of developing diabetes. Data for 2014/15 showed that the practice performed highly for monitoring and treating patients with diabetes and had completed 100% of reviews with patients.

• The practice takes a truly holistic approach to assessing, planning and delivering care and treatment to people who use services. In particular, for people who are suspected to have or are diagnosed with dementia. Their care and treatment is overseen by a GP partner with extensive experience and works closely with hospital specialists in the older people mental health services. All of the staff have had dementia care training and several examples were seen demonstrating that patients were treated with dignity and received compassionate patient centred care.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We visited the surgery and we met and spoke with nine people. This number included two representatives of the Patient Partnership Group (PPG). We spoke with GPs, practice nurses and healthcare assistants who were on duty. We obtained information and support from the administration staff which included the temporary practice manager and receptionists. We observed how the surgery was run and looked at some of the facilities and information available to patients. We used information from the services own quality monitoring and from the PPG.

When we spoke with people about their experiences of the surgery they told us they were very happy with the treatment and support they received. We heard comments such as “Excellent”, “Brilliant” and “Always a positive experience.” Of the nine people we spoke with only one person expressed they felt their treatment had not run smoothly, they told us “Each doctor I see has a different idea.” However, they did add they were not specifically worried by this and on the whole they found they had the care and treatment they needed.

People told us about their experiences with staff of all levels at the surgery. People were very happy and found that staff were approachable, friendly and supportive. People said, “Staff are usually lovely,” “Able to speak to them, approachable and listen,” and “Very polite.” People told us this had not always been so, one person told us, and “Things have really improved, no problems.” They found the atmosphere at the surgery comfortable, professional and not impersonal.