We carried out an announced comprehensive inspection at OHP-Lordwood House Medical Practice on 11 February 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service is 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.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm. They had taken action to further improve and strengthen safeguarding arrangements within the practice.
• The practice proactively used learning from incidents to develop staff to meet patients needs. For example, transgender prescribing and domestic violence training.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• Feedback from patients was positive and survey results showed satisfaction was mainly higher than local and national averages in a number of areas. Staff were aware of areas for further improvement and actively addressing them.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way. They were delivered in a flexible way that ensured choice and continuity of care,

We rated the practice as outstanding for providing well-led services because:

• The way the practice was led and managed promoted the delivery of high-quality, person-centre care. There were innovative approaches to providing integrated person-centred care. Leaders demonstrated proactive engagement with stakeholders as well as the ability to drive an evolving governance structure.
• The practice was involved in a range of pilot schemes; they identified areas where there were gaps in provision locally and had taken steps to address them.
• The culture of the practice and the way it was led and managed drove the delivery and improvement of high-quality, person-centred care.

We saw one outstanding feature:

• The practice went beyond the requirements of a General Medical Service Contract (GMS). The practice held an in-house dermatology clinic which was set up to reduce waiting times for patients who would normally be referred to secondary care. This service was self-funded by the practice. Clinicians within the medical group also offered Musculoskeletal (MSK), sports and exercise medicine appointments. The practice produced evidence that showed the patients were pre-booked four to five weeks in advance demonstrating a shorter waiting time than secondary care outpatient appointments.

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

• Continue taking action to improve the uptake of childhood immunisations and national screening programmes such as cervical screening.
• Continue taking action to ensure induction processes were completed in line with the practice policies and procedures.
• Improve the identification of carers to enable this group of patients to access the care and support they need.
• Continue looking at ways and taking action to improve exception reporting rates.

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

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care