Letter from the Chief Inspector of General Practice

We inspected this service on 19 May 2015 as part of our new comprehensive inspection programme.

The overall rating for this service is outstanding. We found the practice to be good for providing safe, caring and well led services and outstanding for providing effective and responsive services.

The practice was outstanding at providing services for people with long term conditions and people in vulnerable circumstances. The practice was good at providing services for older people, families, children and young people, the working age population and those recently retired and people experiencing poor mental health.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from incidents were maximised.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.

• There were systems in place to keep patients safe from the risk and spread of infection.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Information about how to complain was available and easy to understand, with easy read information available for people with a learning disability to use should they prefer.
• The practice held regular multidisciplinary clinical team meetings to discuss the needs of complex patients, for example those with end of life care needs or children who were at risk of harm.
• The practice had a clear vision which had quality and safety as its top priority. High standards were promoted and owned by all practice staff with evidence of team working across all roles.
• The practice had an open culture that was effective and encouraged staff to share their views through staff meetings and significant event meetings.

We saw several areas of outstanding practice including:

• Two new staff roles had been created (as part of a CCG led initiative utilising Avoiding Unplanned Admissions enhanced service funding) for patients in the community, a Care Home Advanced Nurse Practitioner (ANP) and a Community ANP. The care home ANP worked to reduce unplanned hospital admissions. This role was created 12 months ago and we saw evidence of the positive impact this had had for patients. As a result of this the practice has utilised funding to make this role a full time position. The community ANP arranged phone calls and or visits to frail and elderly patients, including those who were recently discharged from hospital, to assess their needs and offer support. This service, introduced in April 2015 has provided patients with health assessment, medical care and support within their home.

• The practice worked with the Worcestershire Alliance Board in partnership between Worcestershire Health and Care NHS Trust and South Worcestershire Healthcare as part of a Pro-Active Care Team (PACT). This team cared specifically for those patients who were on the unplanned admissions register to avoid further unplanned admissions to hospitals. Nationally reported data showed that the practice performed well against indicators relating to unplanned admissions. For the year ended March 2014 Pershore Medical Practice were 2% lower than the national average for admissions.

• A range of services were provided by the practice to meet the needs of patients with long term conditions. Three practice nurses were specifically trained in the management of diabetes care and this included a commitment to the Diabetic Expert Patient Programme which educated patients to manage their conditions. The practice was one of the highest performing practices in South Worcestershire for the care for diabetic patients. There was a high uptake of flu vaccines (99%) and foot examinations (93%) for diabetic patients.

• Pershore Medical Practice had looked for innovative ways to develop services for patients in their area. They had developed a project led by the practice manager at the practice, and initiated a meeting with two other local practices in the Pershore area. They had sought agreement to work together as a local cluster on a range of projects. The projects included shared skills and expertise and also involved working with members of the CCG and Age UK. As a result of this they had developed a shared referral process with another local practice where skills and expertise were made available to all patients at both practices. For example, one of the GPs provided a secondary Ear, Nose and Throat (ENT) service for both Pershore practices, principally dealing with ear infections and wax clearance where syringing may cause harm to the patient. The practice told us this provided a fast, flexible and local service as an alternative to hospital visits that ensured a better outcome for patients as they were able to access this service locally and promptly. The practice looked to extend these services for patients early in 2015.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We reviewed the information available to us about Pershore Medical Practice on 11 May 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.