Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Southdene Medical Centre on 24 November 2016. Overall the practice is rated as outstanding.

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

Patients were protected by a strong comprehensive safety system and there was a focus on openness, transparency and learning when things went wrong. The practice had a strong system in place for recording, monitoring and learning from significant events, accidents, complaints and reporting.

• The practice used innovative and proactive methods to improve patient outcomes. The practice had a high rate of clinical audit for their size.

• Outcomes for patients who use similar services were consistently better than expected when compared with similar services. Data showed that the practice was performing highly when compared to practices nationally and in the Clinical Commissioning Group. The latest publically available data from 2015/16 showed the practice had achieved the maximum points available to them for 2015/16 (100%), with a clinical exception rate of 8.2%. This was above the England average of 95.3%, and their clinical exception rate was below the England average of 9.8%.

• The practice used creative approaches to care and treatment and placed a strong emphasis on patient education. Staff were consistent and proactive in supporting patients to live healthier lives through a targeted approach to health promotion. Information was provided to patients to help them understand the care and treatment available.

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

• The practice reviewed the needs of their local population and engaged with the NHS England Area Team and clinical commissioning group (CCG) to meet the needs of the individual patients to ensure flexibility, choice and continuity of care.

• 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.

• Patients could access appointments and services in a way that suited them. They said they were able to get an appointment with a GP when they needed one, with urgent appointments available the same day.

• The leadership, governance and culture were used to drive and improve the delivery of high-quality person-centred care. The practice had a clear vision which had quality and safety as its top priority.

• There was a clear leadership structure in place and staff felt supported by management. The practice sought feedback from staff and patients, which they acted on.

• Staff throughout the practice worked well together as a team.

We two areas of outstanding practice which were:

• The practice had all-encompassing systems and processes in place to ensure that patients received high quality care and treatment. These included learning from significant events, triggering clinical audits and then changes in clinical practice which improved patient care. For example, One of the GP partners kept a folder of NICE guidance updates which they reviewed at clinical meetings to ensure they were followed and actioned. They took action as appropriate with regards to existing patients and updated templates and guidelines and protocols the practice had in place. The practice had structured tiered templates on the practice intranet system to obtain information on medical conditions to improve patient care.
• The practice placed a strong emphasis on patient education. In addition to the usual education provided to patients during regular appointments they arranged an education programme with diabetic patients with a local renal consultant in May 2016. The practice monitored the personal diabetes control of the patients who attended this session and found that 38% of patients who attended (eight) lost weight and improved the control of their diabetes.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice