Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Longtown Medical Centre on 3 November 2015. Overall the practice is rated as good.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
• Risks to patients were assessed and well managed.
• 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 were able to get an appointment with a GP when they needed one, 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 in place and staff felt supported by management. The practice proactively sought feedback from staff and patients, which they acted on.

• Staff throughout the practice worked well together as a team

• Staff had received training appropriate to their roles.

• Feedback from patients was overwhelmingly positive and the practice achieved high scores in the National GP Patient Survey.
• Appointments could also be booked via a mobile device ‘App’.

We saw several areas of outstanding practice including:

• Despite scoring well in the National GP Patient Survey in relation to getting through to the practice on the telephone, a monitoring system had been introduced, which showed, for example, the number of calls waiting and any abandoned calls. Staff told us they wanted to further improve patient access.

• Managers were aware of the pressures on general practice and had implemented a ‘change framework’ to aid the practice’s future development. Staff had received training in various areas, including the ‘lean methodology’ (the lean methodology had been adapted by NHS England’s Sustainable Improvement Team and is an approach to improve flow and eliminate waste). This had resulted in a number of areas of waste being identified and actions taken to ultimately improve patient care.For example, staff had reported that patients were not always signposted to the correct service at the correct time; wasting appointment and clinical time. Staff said this could be improved by reception staff asking the right questions when patients contacted the practice. The team worked together and produced a telephone standards guide for staff to follow. The benefits were then analysed, these included, providing the patient with a better experience and better use of time as they would be booked in to see the most appropriate clinician.

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

• Implement arrangements to ensure medicines are stored securely.
• Continue to take steps to set up a patient participation group.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Longtown Medical Centre is based in a modern shared community practice building, where a wide range of other services such as district nurses and health visitors also operate.

There are three GP’s at the service, with one off on long term leave covered by locums. These are supported by two practice nurses, a nurse practitioner, a healthcare assistant, and a team of reception, administrative and management staff.

The service is registered with CQC for the regulated activities of treatment of disease, disorder and injury, and diagnostic and screening services. Maternity, midwifery and family planning services are also registered, as are minor surgical procedures.

People described staff and doctors at the service as caring, conscientious and helpful. Suitable arrangements were in place for people to book appointments in advance and to meet the needs of people who required more urgent appointments’

Appropriate timely referrals and investigations were carried out, and staff supported people to manage and improve their health. The treatment and consulting rooms were clean and tidy. Medical instruments were single use only and disposed of correctly. Other equipment was cleaned and maintained properly.

The practice manager and other staff had developed clear objectives for the future of the practice, and the practice aimed for continuous improvement.