Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Milton Abbas on 28 June 2016. Overall the practice is rated as outstanding.

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

• Staff 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.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, the practice directly employed a member of staff and maintained a suitable vehicle for them to support local patients by delivering medicines to their homes in this rural area.
• Feedback from patients about their care was consistently positive.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group. For example, the practice had provided treatment rooms for clinics and resources for the health visitor team at the branch location. The practice had also successfully introduced a phlebotomy service at the branch location as a result of patient feedback.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• This dispensing practice had safe and effective systems for the management and dispensing of medicines, which kept patients safe.
• The practice actively reviewed complaints and how they are managed and responded to, and made improvements as a result.
• The practice had a clear ethos which had quality and safety as its top priority. The ethos was to provide the highest standard of individualised healthcare in a safe, friendly and welcoming environment. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.
• The practice provides regulated activities from two locations. The main practice is located at Milton Abbas Surgery, Catherines Well, Milton Abbas, Blandford Forum, Dorset DT11 0AT. The other location is Milborne St Andrew Surgery, Milton Close Road, Milborne St Andrew DT11 0DT. The practice has the same management team, GPs and patient list across both locations. We visited both of these locations during our inspection. This report refers to our inspection of the location at Milton Abbas. A separate report which can be found on our website www.cqc.org.uk refers to the other location at Milborne St Andrew.

We saw several areas of outstanding practice including:

The regular and consistent sharing of best practice with neighbouring practices by forming working groups to discuss significant events, adult and child safeguarding, dispensing, prescribing, and a military veteran’s policy. GPs were open to new ideas and learning by sharing their own annual appraisal outcomes with each other and then using their shared resources to achieve these outcomes and deploying their expertise as a team.

Innovative in providing care and services to its patients by setting up an Integrated Nursing Team (INT) combining the roles of practice and community nurses, carrying out home visits across this large rural area 365 days a year from 8:30am to 5.30pm. The INT supported patients by setting up care packages including physiotherapy and occupational therapy, to help patients avoid an extended stay in hospital.

Successful deployment of a dedicated carer’s lead had identified 4% of the practice population as being carers. Carers could make appointments with the carer’s lead, receive home visits, and joint visits with GPs. The practice had funded a local gym to support and promote a healthy lifestyle for patients. There was a voluntary patient transport service and an efficient medicine delivery service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice