Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Littlewick Medical Centre on 17 February 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. The practice ensured that opportunities for learning were maximised.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment. Some clinical staff had undertaken additional training to enhance their skills and had developed areas of special interest to support them in taking lead roles within the practice.
• The practice used proactive methods to improve patient outcomes. For example, the practice ran dedicated child sessions alongside their immunisation clinics which enabled parents to interact whilst children could play and use other services such as infant weighing.
• Feedback from patients about their care, and their interactions with all practice staff, was generally positive. Patients said they were treated with compassion, dignity and respect and they were involved in their care and treatment.
• Patients said they generally found it easy to make an appointment with a GP with urgent appointments available the same day.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. For example the practice was working with the local MP to set up a health and jobs fair for the local community.
• Staff demonstrated a passion to engage with their patients and the wider community to promote health and wellbeing in addition to reducing social isolation. This was achieved by offering a wide range of services such as monthly coffee mornings for carers.
• 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. For example changes had been made to the appointments system including the introduction of a new telephone system which had increased the call handling capacity of the practice and reduced call waiting times.
• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand.
• The practice had a clear vision which had quality and safety as its top priority.

We saw several areas of outstanding practice including:

• The practice had designed and delivered a wide range of services and groups to promote the health and wellbeing of patients within the wider community to reduce social isolation. These groups included craft, knitting and bingo groups which were all held at the practice on a regular basis. Additionally groups and services were offered by the practice to promote healthier living. These included a falls prevention class and weekly walking groups.
• A system whereby the wounds of patients were attending for dressings were photographed. This enabled the practice to monitor healing and seek expert advice and assistance from the tissue viability team where this was required. Consideration was being given locally as to how this system could be rolled out more widely.
• Strong links had been developed with the local community and the practice involved people in the practice to promote health and wellbeing. For example, the practice was working with their local MP to support a jobs and health fair. In addition the practice had delivered informational talks to local schools. The practice director also sat on the advisory board for the local children’s’ centres.
• The practice had won a national award from the BMJ as Primary Care Team of the Year for work on an outreach project targeted at the vulnerable elderly. This involved work with social care and energy providers and focussed on ensuring that patients were living in healthy environments.

However there were areas of practice where the provider should make improvements:

• Review arrangements in place to ensure patient groups directions are always completed in full to confirm that the practice has adopted the direction.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice