Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Page Hall Medical Centre on 26 July 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it difficult at times to make a routine appointment although urgent appointments were available the sameday through the nurse telephone triage system.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw areas of outstanding practice:

• The practice had set up a working group with the local schools to look at attendance issues contributed to by minor illnesses. The practice had arranged to have self help leaflets translated into Slovak to assist patients. The practice had worked with school nursing teams to support pupils where there were specific concerns.

• The GPs told us they had agreed to complete death certificates during out of hours periods to facilitate and support patients whose religion required the burial to take place as soon as possible after death.
• The practice had developed a new patient registration appointment system with interpreters on site which offered an enhanced level of screening and opportunistic vaccination as well as orientation to the NHS for new migrants. The GP told us this had uncovered an exceptionally high prevalence of hepatitis B in some communities and the practice had implemented a contact tracing and hepatitis B vaccination programme for their own patients. The GP told us this had been recognised by Public Health England and had triggered a national enhanced service to offer patients who may be vulnerable the Hepatitis B vaccination.

The area where the provider should make improvement is:

• Maintain a complete record of the immunity status of clinical staff as specified in the national Green Book (immunisations against infectious disease) guidance for healthcare staff.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice