Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Marysville Medical Practice, on 24 June 2015. Overall the practice is rated as outstanding.

Specifically, we found the practice to be outstanding for providing effective, caring and responsive services and good for providing safe and well led services. It was outstanding overall for the services it provided to older people; people with long-term conditions; families, children and young people; working age people; people whose circumstances may make them vulnerable and people experiencing poor mental health.

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. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed, with the exception of those relating to recruitment checks.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Staff had received training appropriate to their roles and any further training needs had been identified and planned. The practice valued the importance of quality, improvement and learning and were actively involved in the training and education of GPs, student nurses and counsellors.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Patients rated the practice highly in surveys and described the practice as caring and helpful.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that there was flexibility of access to appointments.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

We saw areas of outstanding practice:

• The practice had developed and led on a project known as the Care Homes Advanced Scheme (CHAS) for care homes in the locality of Shrewsbury and Atcham, Shropshire. The aim of the project was to increase clinical input into care homes. The project was evaluated and recognised by the local CCG as an important initiative in preventing unplanned hospital admissions and providing more continuity to patients’ in care homes. All GP practices had agreed to provide a service to a small number of care homes. Before this, patients living in care homes received care and treatment from as many as 14 practices.

• The practice had developed easy read leaflets which were given to patients with a learning disability to help them understand the care and treatment they received.

• The practice was committed to providing access to as many services as possible at the premises. Physiotherapy, counselling and chiropody services were provided for its registered population. Access to additional services included; British Pregnancy Advisory Service, regional hearing service, pain management service, vasectomy surgery and dermatology surgery were provided for patients registered at the practice and those from other practices. This allowed patients to access local care at the practice rather than a hospital setting.

There were two areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Review complaints over time to identify any themes or trends.

• Continue to review recruitment procedures to ensure that all staff who are involved in the direct care of patients such as providing treatment or chaperone duties are risk assessed to determine if a Disclosure and Barring Service (DBS) check is required.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice