Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Simmondley Medical Practice on 20 July 2016. The overall rating for the practice was good, with one area, effective rated as requires improvement. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for Simmondley Medical Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 31 July 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 20 July 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as Good.

Our key findings were as follows:

• The recall system ensures patients with long term conditions were reviewed and monitored in line with good practice.
• Data provided by the practice for 2016/2017 shows patient outcomes were in line with or above those locally and nationally.
• The practice now has a system in place to follow up those patients who failed to attend reviews and where appropriate the practice nurse and health champion would carry out home visits.
• There is now a robust system in place for recording, reviewing and sharing learning following significant events.
• An up to date register of vulnerable children, families and adults was now in place.

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 Simmondley Medical Practice on 20 July 2016. Overall the practice is rated as Good.

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. However the provider needs to ensure a consistent method of recording significant events.

• Risks to patients were assessed and managed, with the exception of those relating to safeguarding where systems were not robust.

• 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 used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example the impact of the work carried out by the over 75’s Champion.

• Data showed patient outcomes were in line with or above those locally and nationally. However we found during the inspection that not all patients with long term health conditions were being monitored and reviewed effectivley.

• Feedback from patients about their care was consistently and strongly positive.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a result of feedback from patients.

• Information about services and how to complain was available and easy to understand.

• Patients said they found it easy to make an appointment and that 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 saw areas of outstanding practice, including:

The practice employed an over 75’s Champion whose role was to contact all patients over 75 years to meet, where appropriate, in the patients home to assess needs and provide advice and support to patients and carers, including referrals to social care and community voluntary organisations. Evidence of the impact of this work included adaptations within patients’ homes to reduce the risk of falls and referrals to local voluntary organisations to reduce isolation, both of which helped the practice reduce unplanned hospital admissions.

We saw a strong patient-centred culture. For example the local pharmacy did not deliver prescriptions; as a result for those housebound patients requiring prescriptions, reception staff would deliver prescriptions.

The areas where the provider must make improvement are:

Ensure systems are in place to monitor and review appropriately patients with long term health conditions.

The areas where the provider should make improvement are:

Ensure all significant events are recorded in a consistent way and where improvements are recommended systems are in place to review and monitor the improvements.

The system for recording and maintaining an up to date register of vulnerable families needed to be rationalised following a change in the IT systems to ensure the information is accurate and up to date and all communication with families and external agencies is recorded, including communication in relation to children who have failed to attend for example hospital appointments.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice