Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at St George’s Medical Practice on 10 February 2015. Overall the practice is rated as outstanding.

Specifically, we found the practice to be outstanding for providing responsive and well-led services and was good for providing safe, effective and caring services.

It was rated as outstanding for providing services to people with long-term conditions and working age people (including those recently retired and students). It was good for providing services to older people, families, children and young people, people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia).

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

• The practice had a clear vision which had quality and safety as its top priority. High standards were promoted and owned by all practice staff with evidence of team working across all roles.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, the practice hosted a weekly community clinic which provided a triage service for hip and knee conditions.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet people’s needs.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Patients told us they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Patients told us they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• Information about safety was recorded, monitored, appropriately reviewed and addressed. Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
• Risks to patients were assessed and well managed.
• Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Information about services and how to complain was available and easy to understand.
• 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 several areas of outstanding practice including:

The practice was actively involved in developing and implementing innovative pilot projects with other stakeholders to improve patient outcomes across the wider community. For example:

• the practice had hosted and co-authored a liver screening project along with other health professionals from the Nottingham University hospital and the Rushcliffe clinical commissioning group. This project had improved the diagnostic identification of significant liver disease in patients using a fibroscan and had won an NHS innovations award. This was published in the British Medical Journal after our inspection.

• the practice had hosted a trauma and orthopaedic community clinic since April 2014 as a new model of care. This weekly clinic provided a triage service for a range of hip and knee conditions and was led by a consultant and specialist physiotherapist. An evaluation of the service showed positive outcomes were achieved for patients including timely diagnosis and referrals for further intervention, and efficient use of resources including financial savings in terms of inpatient costs. About 87% of patients who had used the service rated it excellent and 13% rated it good.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice