Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Roundwood Surgery on 11 March 2015. Overall the practice is rated as outstanding

Specifically, we found the practice to be good for providing safe, effective and caring services. It was outstanding for providing responsive and well-led services. We found the practice to be good for providing services for people with long-term conditions, families, children and young people, working age people (including those recently retired) and people experiencing poor mental health (including people with dementia). It was outstanding for providing services for older people and people whose circumstances might make them vulnerable.

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.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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 (PPG).
• Information about services and how to complain was available and easy to understand.
• The practice was the only one to offer an enhanced service to homeless people in the CCG area. They took a proactive approach towards meeting the needs of this vulnerable group of patients and took the service out to a local church which provided meals for homeless people and offered nursing services including dressings, health advice and monitoring as well as opportunistically offering the flu vaccination to prevent ill health. This service had led to some homeless patients feeling comfortable enough to attend the practice to see the GPs.
• Leaders were both visible and supportive. They were committed to improving the services for patients within the practice and the wider community and repeatedly volunteered to pilot new ideas and innovations before such innovations were rolled out across the CCG. They invested in their staff and shared this expertise with other practices to improve standards across the wider practice community. For example the electronic system super user offered support, training and guidance to other practice managers.
• The practice had a clear vision which had patient care as its top priority. The practice held regular meetings to discuss business direction and forward planning. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

We saw some areas of outstanding practice:

• The practice was the only practice in the area to offer a service for homeless people and treated these patients in an environment where they felt comfortable by visiting a local church at lunchtimes offering a range of nursing services and opportunistic immunisation against flu.
• The practice had introduced a minor injuries walk-in clinic in response to a review of information about A&E attendances to provide a local service to all patients in the locality and prevent them having to travel and wait for treatment. This had resulted in a reduction in A&E attendances by practice patients of 100 over a 12 month period.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice