Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection March 2015 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Outstanding

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Shanklin Medical Centre on Thursday 23 November 2017 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• The practice worked with other agencies to support patients and protect them from neglect and abuse. Staff took steps to protect patients from abuse, neglect, harassment, discrimination and breaches of their dignity and respect.
• The practice used text messaging reminders for appointments and if they had consent from the patient, results of blood tests for example would also be sent using this method. This helped to improve treatment and supported patients’ independence.

We saw some areas of outstanding practice:

At this inspection we found that the practice had continued to be outstanding in responding to people’s needs.

The practice continued to initiate positive service improvements for its patients that were over and above its contractual obligations. It acted on suggestions for improvements and changed the way it delivered services in response to feedback from the patient participation group. For example by offering patients alternative means of accessing their GP or meeting their healthcare needs. The practice reviewed the needs of its local population and engaged with the NHS England Area Team and Clinical Commissioning Group (CCG) to secure service improvements where these had been identified. The practice played a significant role in instigating health initiatives and worked with the CCG and other practices to secure funding for enhanced services for patients.

For example; Results from the July 2017 annual national GP patient survey showed that patients’ satisfaction with how they could access care and treatment was higher than local and national averages. The practice had scored higher than the clinical commissioning group averages in every question. This was supported by observations on the day of inspection and completed comment cards.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Shanklin Medical Centre on 12 March 2015. Overall the practice is rated as good.

Specifically, we found the practice to be outstanding for providing responsive services. It was good for providing a safe, effective, caring and well led service for all population groups.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example two of the practice nurses had been asked by the Island’s diabetic centre to provide a presentation to all local practices about how they care for their diabetic patients as it had been identified as a model of best practice.
• 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.
• Results from the 2013 GP survey also showed 93.8% of those patients surveyed felt that their overall experience of the practice was either good or very good
• The practice had sufficient resources to meet the needs of the increased population on the Isle of Wight during the holiday season. They had been able to deal with 2000 contacts with temporary residents in the past year.
• Where patients had been affected by something that had gone wrong we saw they had been discussed with the patient and a full explanation given.

• 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.

• 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.
• The practice had a clear vision which had quality and safety as its top priority. A business plan was in place, was monitored and regularly reviewed and discussed with all staff. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

We saw several areas of outstanding practice including:

• The practice had developed a poster campaign ‘Reducing accidental injury and poisoning in young children’ to alert families to the risks to children that could lead to treatment in accident and emergency. This poster was distributed to all children’s centres across the Isle of Wight and, at the practice’s expense, published in the local newspapers.

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

Importantly the provider should:

• Have an up to date Legionella risk assessment as well as a policy for the management, testing and investigation of Legionella.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice