Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Penny’s Hill Practice on 19 October 2016. Overall the practice is rated as good.

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

• There was a strong commitment to providing co-ordinated, responsive and compassionate care for patients, particularly patients with long term conditions and older people who are frail and at risk of social isolation. Examples included a celebratory party with all patients who reached their 90th birthday in 2016.
• Patients experienced flexible services that aimed to provide choice and continuity of care.The practice had three times the national average of patients over 75 years and had developed services to meet their needs. Examples included individualised approach to triage by the patients own GP. Named secretaries liaising with patients for continuity of communication. Fast track and longer appointments for carers and patients receiving care.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• There was a holistic approach to assessing, planning and delivering care and treatment to people using services. Examples included: risks to patients were assessed and well managed by a tracker nursing team who worked closely with GPs.
• 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.
• All of the 47 patients, who used the service, family members and carers, and stakeholders who gave feedback at the inspection were continuously positive about the way staff treated them and other patients. Patient’s told us that it was easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day. 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.
• 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.
• Penny’s Hill Practice was proactive in identifying carers and had a comprehensive overview of their needs and created ways to provide timely support for them.
• The practice had adapted facilities that were dementia friendly. The practice and was well equipped to treat patients and meet their needs.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.

The provider was aware of and complied with the requirements of the duty of candour.

We saw two areas of outstanding practice:

The practice was innovative in trialling the use of encrypted hand held devices for accessing realtime patient information during home visits. GPs reported this facilitated diagnosis, treatment and immediate recording of the outcome of the consultation with patients ensuring more detailed patient records were maintained.

A proactive approach to managing vulnerable patients and had reduced the number of unplanned hospital admissions for vulnerable patients with chronic health conditions. Data from the provider showed the practice had exceeded the target of 3.5% reduction set by the Clinical Commissioning Group with a 5.4% reduction, which equated to 31 fewer unplanned patient admissions in 2015/16 compared with the previous year.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice