Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Doctors Hart, Taylor and Huins (Queen Camel Medical Centre) on 22 September 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing caring, well-led, effective, safe and responsive services. It was also good for providing services for the Older patients, Patients with long-term conditions, Families, children and young patients, Working age patients (including those recently retired and students), Patients whose circumstances may make them vulnerable, and patients experiencing poor mental health (including patients diagnosed with dementia).

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed, including those relating to recruitment checks.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff received training appropriate to their roles and any further training needs had been identified and planned.
• Patients said they were treated with a high degree of 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. We saw the practice had received a wealth of positive comments from patients and these were reflected in the comments of patients we spoke with.
• Patients said they found it easy to make an appointment, these could be made with a named GP and there was continuity of care, with urgent appointments available the same day.
• 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.

We noted areas of outstanding practice:

• The practice had a truly holistic approach to assessing, planning and delivering care and treatment and provided outstanding elements of support for patients particularly for patients nearing the end of their life, those who had a recent bereavement and for their carers. Patients in the end stages of their illness were cared for exclusively by their regular GP. The family had access to the home phone number of the relevant GP at this time who provided 24 hour care and support. More than twice the national average number of patients were able to die at home (their chosen location) through care and support provided by the practice.

• There was a proactive approach to understanding the needs of different groups of patients. The practice had a text service for teenage patients allowing them priority access to appointments via text messages to the practice. The service was provided in response to teenage patients saying it was their preferred method of communication. Practice GPs provided a weekly clinic during term time at a local preparatory school with 120 boarders.
• Feedback from patients who used the service was continually positive about the way staff treated them. Patients provided many examples of the caring nature of practice staff. GPs gave them personal phone numbers, visited them in the evenings and at weekends during times of difficulty or bereavement and give additional personal time to talk with family members about medical diagnosis.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should;

• Review procedures for medicines taken to other collection points, to ensure a robust audit trail is maintained.
• Review the fire evacuation procedure to make clearer the roles, responsibilities and procedures for staff and patients.
• Review complaints processes to ensure a clearer record of complaints is maintained and records are retained for the required period.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice