Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Stanley Medical Group on 19 October 2016. Overall, the practice is rated as outstanding.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and 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.
• Patients said they found it easy to make an appointment with a named GP and 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 found the practice governance and performance management arrangements were proactively reviewed and reflected best practice. The practice had invested in the arrangements to support improvement within the practice. They used a method of streamlining their processes to improve effectiveness and efficiency.
• We found the leadership, governance and culture were used to drive and improve the delivery of an efficient and effective service. They drove continuous improvement and supported staff to deliver.
• The provider was aware of and complied with the requirements of the duty of candour.
• There was a strong focus on continuous learning and improvement at all levels. We found safe innovation was celebrated. There was a clear proactive approach to seeking out and embedding new ways of providing care and treatment.

We saw areas of outstanding practice:

• The practice had adapted a process used in industry, called lean methodologies, to streamline their own systems and processes. This had resulted in demonstrable improvements in the management of clinical access for patients and the management of cardio vascular health checks.
• Between 2014 and 2016, the practice invested finances in upskilling GPs within the practice in six clinical areas. The areas were dermatology, gynaecological, ophthalmology, orthopaedics, urology and ear nose and throat conditions. These were the areas the practice had assessed as areas for improvement for managing referrals. The practice could show the impact of this activity through audits of their referrals, which demonstrated improved quality and focus of referral activity.
• The practice was part of a local pilot scheme to identify patients at high risk of developing diabetes, and take a proactive approach to identifying, reviewing, engaging patients in the prevention of onset for diabetes, and offering diabetes education via the local Diabetes Prevention Program. The practice had identified 575 patients with impaired glucose regulation. Less than 8% (42 patients) were subsequently confirmed as diabetic. The remaining 92% were included in the practices recall for a review, under the long term condition review process.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice