Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Stewart Medical Centre on 1 August 2016. Overall, the practice is rated as good.

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

• There was a system in place for the reporting and recording of significant events. Learning was applied from events to enhance the delivery of safe care to patients.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• A programme of clinical audit reviewed patient care and ensured actions were implemented to improve services as a result.
• The practice planned and co-ordinated patient care with the wider multi-disciplinary team to deliver effective and responsive care to keep vulnerable patients safe.
• The practice had an effective appraisal system in place and was committed to staff training and development. The practice team had the skills, knowledge and experience to deliver high quality 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. The practice analysed and acted on feedback received from patients.
• Patients mainly provided positive views on their experience in making an appointment to see a GP or nurse.
• The practice offered a range of options to consult with a clinician. A GP triaged calls for requests to be seen on the day, and ensured that any patient requiring an urgent appointment was seen. Appointments could be booked in advance and telephone consultations were available. Longer appointments were available for those patients with more complex needs.
• The practice was maintained to a high standard with good facilities and was well-equipped to treat patients and meet their needs.
• There was a clear leadership structure in place and the practice had a governance framework which supported the delivery of good quality care. Regular practice meetings occurred, and staff said that GPs and managers were approachable and always had time to talk with them.
• The practice had submitted a successful funding request to pilot two dementia support workers within primary care. The pilot scheme was to be formally evaluated to assess the outcomes it had achieved for patients and their carers.
• Information about how to complain was available upon request and was easy to understand. Improvements were made to the quality of care as a result of any complaints received.

We saw the following area of outstanding practice:

• The practice had developed an expert patient programme. This enabled patients with a new diagnosis to be able to speak with another patient with personal experience of dealing with the same condition.

The areas where the provider should make improvement are:

• The practice needed to ensure that records clearly documented the follow-up actions taken with children who could be vulnerable, and had not attended a hospital appointment.
• The practice reviewed patients who had been prescribed high-risk medicines and there was monitoring in place to ensure prescribing remained safe. The system in place needed to be strengthened to ensure that reviews were always undertaken within recommended timescales.
• Review the documented evidence to support staff induction programmes.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice