Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Marsden Road Health Centre on 24 March 2016. 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. All opportunities for learning from internal and external incidents were maximised.
• Risks to patients were assessed and well managed.
• The practice carried out clinical audit activity and were able to demonstrate improvements to patient care as a result of this.
• Feedback from patients about their care was consistently positive. Patients reported that they were treated with compassion, dignity and respect.
• The practice had obtained excellent National GP Patient Survey results in relation to care and treatment received and the ease of being able to get an appointment. 95% of patients described their experience of making an appointment as good compared to the CCG average of 78% and the national average of 73%.
• Urgent appointments were usually available on the day they were requested. Pre- bookable appointments were available within acceptable timescales.
• The practice had a number of policies and procedures to govern activity, which were reviewed and updated regularly.
• The practice had proactively sought feedback from patients and had an active patient participation group. The practice implemented suggestions for improvement and made changes to the way they delivered services in response to feedback. For example, they had introduced Saturday morning GP appointments.
• The practice used the Quality and Outcomes Framework (QOF) as one method of monitoring effectiveness.
• Information about services and how to complain was available and easy to understand.
• The practice had a clear vision in which quality and safety was prioritised. The strategy to deliver this vision was regularly discussed and reviewed with staff and stakeholders.

We saw several areas of outstanding practice:

• The practice had effective systems in place to support patients with long term conditions. They had adopted an approach that ensured patients with long term conditions received proactive, holistic and patient centred care. In addition to the usual range of conditions for which long term condition reviews were offered the practice also offered reviews for conditions such as pre-diabetes, chronic kidney disease, rheumatoid arthritis, peripheral vascular disease and recurrent depressive disorder.
• The practice had created a process to ensure housebound patients with long term conditions were offered a fully comprehensive annual review. They had achieved this by ensuring practice health care assistants attended home visits for long term condition reviews armed with all necessary background information and diagnostic equipment to be able to carry out a fully comprehensive review. The results were then reviewed by a clinician who would subsequently contact the patient to carry out a follow up telephone review. The success of this initiative had led to it being adopted by the local CCG for use by their community nurses.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice