Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at St James Medical Practice on 10 February 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well-led services. It was also good for providing services 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 to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• 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.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available on 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.

The overall rating for St James Medical Practice is ‘Good'.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

This practice is rated as Good overall. (Previous rating September 2015 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at St James Medical Centre on 24 July 2018. We carried out this inspection as part of our inspection programme.

At this inspection we found:

• The practice partnership had changed during the preceding 18 months, new clinical staff had been employed and additional management support had been put in place. The practice had reviewed the skill mix within the teams and had employed advance nurse practitioners and an emergency care practitioner offering greater flexibility of appointments.
• The practice had clear and comprehensive 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.
• The practice had implemented a new appointment system ensuring every patient who requested an appointment on the day was spoken too by a clinical staff member. Patients who wished to see a clinician of their choice were able to pre-book an appointment. Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• Practice staff told us they worked as a cohesive team to care for their patients.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• The practice staff felt they were well supported and valued by the partners.

The areas where the provider should make improvements are:

• Continue to develop systems and processes to identify carers to ensure they receive appropriate support.
• Embed the system to ensure that all prescription stationary is recorded and monitored.
• Continue to monitor and ensure safe prescribing in respect of Hypnotics medicines.
• Continue to develop systems and processes to encourage and improve the uptake of the national cervical screening programme.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.