We carried out an announced comprehensive inspection at OHP Church Stretton Medical Centre on 4 February 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected

• information from our ongoing monitoring of data about services and

• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and good for all population groups.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.

• There was a positive culture for reporting, recording and learning from signiificant events.

• Patients received effective care and treatment that met their needs.

• Clinical audits were carried out and the results of these were used to improve outcomes for patients.

• Staff dealt with patients with kindness and respect and involved them in decisions about their care.

• Data form the national patient survey showed the practice was rated higher in most indicators than local and national averages for providing caring and responsive services.

• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.

• Staff were supported in their roles and with their professional development.

• Regular meetings were held with staff to communicate to share information and practice performance.
• Leaders were knowledgeable about issues and priorities relating to the quality and future of services. They understood the challenges and were addressing them.

We saw areas of outstanding practice:

• The practice had developed and implemented an in-house safety netting system for monitoring patients on high risk medicines on shared care arrangements. This ensured patients were only prescribed medicines following effective review of their required blood tests.

• As part of a recent development between the practice and local primary and secondary schools, the appointed safeguarding lead had attended school link mental health sessions. These provided an opportunity to discuss problems and difficulties faced by schools when dealing with vulnerable children. As a result of these sessions, a GP-Schools Link form was developed and implemented allowing information to be shared between the practice, families and schools.

Whilst we found no breaches of regulations, the provider should:

• Further develop health and safety risk assessments and update the business continuity plan and the practice policies and procedures.

• Ensure all staff recruitment files contain the required checks including locum staff.

• Develop a formal system for reviewing nurse clinical decisions made in minor illness/injury clinics held.

• Provide the escalation route to complainants should they not be happy with the outcome or the management of their complaint.

• Review the Quality Outcomes Framework (QOF) exception reporting for patients with diabetes.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice