We carried out a comprehensive announced inspection at Nelson Medical Group on 12 March 2015. Overall, the practice is rated as good. Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well led services. The practice was also good at providing services for the six key population groups we looked at during the inspection.

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. Information about safety was recorded, monitored, reviewed and addressed. However, the actual recording of significant events could be improved;
• Risks to patients were assessed and well managed;
• The practice was clean and hygienic, and good infection control arrangements were in place;
• Patients’ needs were assessed and care was planned and delivered following best practice guidance;
• Most patients told us they were treated well and received a good service. Findings from the most recent National GP Patient Survey showed patient satisfaction levels were varied, but most were broadly in line with the local Clinical Commissioning Group (CCG) and national averages. Good feedback was received about the care and treatment provided by the practice nurses. However, not all patients were satisfied with access to appointments or appointment waiting times. This had been acknowledged by the practice and staff were taking action to address these concerns in collaboration with their patient participation group;
• Information about the services provided by the practice was readily available and easy to understand, as was information about how to raise a complaint;
• The practice had satisfactory facilities and was suitably equipped to treat patients and meet their needs;
• There was a clear leadership structure and good governance arrangements. The practice actively sought feedback from patients.

However, there was an area of practice where the provider needs to make improvements. Importantly the provider should:

• Ensure that significant events are recorded fully and include any action taken and lessons learnt.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection March 2015 – Good)

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 Nelson Medical Group on 23 November and 7 December 2017 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to keep patients safe and safeguarded from abuse.
• 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 routinely reviewed the effectiveness and appropriateness of the care they provided. They ensured that care and treatment was delivered according to evidence- based guidelines.
• Quality Outcomes Framework (QOF) for 2016/17 showed the practice had achieved 100% of the points available to them for providing recommended treatments for the most commonly found clinical conditions.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• The practice organised and delivered services to meet patients’ needs. They took account of patient needs and preferences.
• Patients were able to access care and treatment from the practice within an acceptable timescale for their needs.
• There was a focus on continuous learning and improvement at all levels of the organisation. The practice proactively used performance information to drive improvement.

The one area where the provider should make improvements is:

• Investigate how the published QOF exception rate data for 2016/2017 is different to that captured on their own systems.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice