Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Orchard Medical Practice on 4 August 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 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 sent letters to all eligible patients for the flu vaccine to attend an annual event where they hired a room. The practice provided refreshments and enabled patients to come and receive their inoculation and meet up with other people at the same time.

• The practice manager telephoned anyone who gave feedback positive or negative to the practice to thank them personally and to let them know how appreciated it was.

• The practice’s computer system alerted GPs if a patient was also a carer.The practice had identified 764 patients as carers (4.1% of the practice list).

• Staff were motivated and inspired to offer kind and compassionate care and worked to overcome obstacles to achieving this.

• Feedback from patients about their care was consistently positive.

• The practice staff were committed to going the extra mile for their patients. In 2015 one of the nurses was awarded practice nurse of the year and the reception staff, a HCA and the practice manager had received an award for ‘going the extra mile’. These awards were from the CCG following nominations by the patients of the practice.

• 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 increasing the number of reception staff and the introduction of ‘one problem clinics’.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice actively reviewed complaints (verbal and written) and how they are managed and responded to, and made improvements as a result.
• The practice had a clear vision which had quality and safety as its top priority.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.
• Staff were proud of the practice and were constantly involved in developing and supporting new ways of providing treatment.

We saw areas of outstanding practice including

• The practice had produced a video that was played in one of the waiting areas which included some of the GPs and some members of the PPG. This was to encourage patients that maybe lonely and isolated to come and join the PPG or to join the walking group that had been set up in June 2015 in conjunction with members of the PPG. At the time of our inspection there were 15 patients that regularly attended. There were two walks that left from the practice each week where patients or the general public could join in for free and improve their health and wellbeing and meet other people. The practice had received feedback from patients saying how their fitness levels had improved and a consultant had written to the practice after seeing a patient that had started with the walking group and had improved with their wellbeing.

• The practice was passionate about helping people. The practice had a taxi fund which had been set up with the Patient Participation Group (PPG) in April 2016 to enable patients that were unable to get into the practice or those that needed to go to accident and emergency or the hospital were given money for the taxi. The fund had helped five people so far for example: a vulnerable drug user who could not and would not have gone to hospital with an infected ulcer as they could not afford it so the taxi fund was used; and a patient with long term conditions who had not been attending for reviews had telephoned the practice with a number of problems. This patient could not get into practice and therefore the taxi fund was used and the patient came into the practice for an appointment and also had a review. This patient was now a regular attender for their reviews.

• Appointments for mental health reviews were offered on Saturday mornings for patients to attend when surgery is quieter and less threatening this also meant that patients could be accompanied by friends or relatives who might be working Monday to Friday. Sit and wait appointments were also available for those patients of no fixed abode and those patients with mental health issues.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice