Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Marus Bridge Practice on 5 September 2016. Overall the practice is rated as outstanding.

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

• Throughout the inspection the practice demonstrated positive examples of holistic responses to patients’ needs, resulting in positive health and social outcomes.
• All staff fully understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised and transparent throughout the whole partnership.There were strong and visible clinical and managerial leadership and governance arrangements in place to support development and implementation of the learning cycle.
• Throughout our inspection there was a strong theme of bespoke education and training programmes which had been developed to maintain safe processes and align with in-house processes. These were overseen and maintained by all the clinical partners.
• The practice had a programme of continuous quality improvement through clinical and internal audits, and these were used to monitor quality and to make improvements.
• Feedback from patients about their care was consistently positive with many examples of the practice’s caring nature and going above and beyond to help patients.
• Staff were well supported and all felt a strong sense of team work and were very happy.
• The practice used their knowledge of the local community and patient population as levers to deliver high quality and person centred care.

We saw several areas of outstanding practice:

The practice had been heavily involved in embedding training to follow in-house bespoke policies and staff development for non-clinicians and clinical staff, which had been shared with the CCG and rolled out to other practices in the wider area by practice staff. For example:

• The healthcare assistant received training to support the transition from administration to healthcare assistant; training topics included clinical skills and infection control.
• The development and roll out of a training programme designed to support nurses from other care settings transition into primary care.
• Two staff were “vaccinations and fridge champions” and a course was designed to build confidence.

The practice designed several in- house policies to review systems or incidents. For example, a mobile phone policy for teenagers, due to the practice being highly aware of consent and confidentially issues with teenagers’ mobile numbers were documented.

There was a strong focus on clinical IT development which we saw both with GPs and the nursing team. For example, a learning disabilities template was designed; there was a dedicated learning disability champion who was supported by the clinical lead.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice