Letter from the Chief Inspector of General Practice

This practice is rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Midway GP Partnership on 10 January 2018. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice had systems and policies in place to safeguard children and vulnerable adults.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Appropriate pre-employment checks were in place that included checks of professional registration where relevant.
• Staff had lead roles within the practice. For example, one of the GPs was the lead for safeguarding and a member of the nursing team was the lead for infection prevention and control.
• Clinical staff had received additional training to manage the care of patients with diabetes and had developed their own treatment template.
• A programme of clinical audit was in place that demonstrated quality improvement.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw one area of outstanding practice:

• The practice had achieved the Purple Star award for its care of patients with learning disabilities. This award is from Hertfordshire County Council’s Health and Community Services for providers who improve their services for people with learning disabilities. The award was achieved following the successful completion of a programme of training by all of the practice staff. The training included how to communicate with patients with learning disabilities and their families and how to be flexible with appointment booking. For example, offering appointments during quieter times and offering home visits. Easy read leaflets were available and surveys of patients with learning disabilities were carried out using pictures of happy and sad faces. The practice were the first GP practice in the local area to achieve this award.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Midway GP Partnership on 24 February 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.

• 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.
• Feedback from patients about their care and staff behaviours was consistently and strongly positive. Patients said they were treated with compassion, dignity and respect and they were very 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 found it easy to make an appointment with a named GP and that there was continuity of care, 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 and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.

The areas where the provider should make improvements are:

• Ensure that all clinical staff are knowledgeable on the standard precautions used to treat patients in the isolation room.
• Take steps to ensure that hot water temperatures at the practice are kept within the required levels.
• Ensure that all staff employed are receiving appropriate supervision and appraisal.
• Ensure that a documented policy on patient consent is in place.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice