Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Spa Medical Practice on 20 September 2016. Overall the practice is rated as good.

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

• There were effective systems in place to monitor and maintain patient safety in the practice.
• Staff understood their responsibilities to raise concerns and to report incidents and near misses. Incidents were regarded as opportunities for learning across the practice team and for improving patient care.
• Patients’ needs were assessed and care delivered in line with best practice guidance.
• Staff had received training to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients told us that they were treated with kindness, dignity and courtesy and that they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• All patients had a nominated GP, which provided continuity of care. Family members had the same nominated GP.
• Patients said they found it easy to make an appointment with a named GP and that they appreciated the continuity of care. Patients could get urgent appointments the same day.
• There was strong collaboration between the practice and the Patient Participation Group.
• There was active liaison with the Worcestershire Association of Carers. 3% of patients had been identified as carers.
• The Spa Medical Practice was the base for the town INR service (a service to monitor patients on a blood-thinning medicine).
• A GP had initiated the diagnostic ultrasound service, which was funded by the Clinical Commissioning Group.
• The practice proactively initiated alternative ways to improve patient outcomes. For example, it was the first in the county to employ an advanced nurse practitioner who was a qualified Acute Care Practitioner.
• The practice was located in purpose-built premises and was well equipped to treat patients and meet their needs.
• There was a strong and visible clinical and managerial leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour. 

We saw several areas of outstanding practice including:

• The business manager had been instrumental in setting up the Social Prescribing Pilot project in the Locality. The project provided advice and support for patients with social needs or for those who had mental health issues.
• The practice provided a minor injuries service, because the practice was situated more than five miles from the nearest A&E department. The minor injuries service was open between 8am and 6.30pm for any new injury that had occurred within the past 48hrs. This was a walk-in service for any patient.
• A Gateway worker and a psychologist from the Primary Care Mental Health Service held clinics at the practice every Monday. Mental health counselling was also available every Thursday.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice