Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Strensham Road Surgery on 27 October 2016. Overall the practice is rated as good.

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

• There were proactive arrangements to safeguard children and vulnerable adults from abuse, and these met with the requirements of local agencies and current legislation.
• The practice had a system to report and record incidents and significant events. Changes were implemented to prevent incidents happening again.
• Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were higher than CCG and national averages. The most recent published results (for 2015/2016) showed the practice had achieved 100% of the total number of points available, compared with the Clinical Commissioning Group (CCG) average of 97% and the national average of 95%.The patient population had high levels of social deprivation and cultural diversity which made it more challenging to engage patients with services. This made the practice’s high level of performance in several key areas particularly impressive.
• The practice used benchmarking alongside a program of clinical audit was used to monitor and improve the quality of patient care.
• Staff demonstrated that they had the skills, knowledge and experience to deliver effective very high standard of care and treatment.
• Results from the National GP Patient Survey published in July 2016 showed that the practice’s performance in patients’ satisfaction with the practice staff, the care they received and how they could access care and treatment was higher than average.
• Staff we spoke with were patient focused and eager to provide a friendly and accessible service. We observed staff members to be helpful to patients and treat them with dignity and respect.
• The practice recognised the needs of its population group and strove to offer the best care possible. For example staff spoke a number of different languages to accommodate the diverse local population.
• The practice had also increased its appointment availability to meet patient demand, and at the time of the inspection was offering 19% more appointments per year than the national average.
• Information was available to help patients understand the complaints system. There was an up to date complaints and comments leaflet displayed in the patient waiting area and this had a feedback form attached. Details of how to complain were also included in the practice leaflet and on the website.
• Staff described the culture of the practice as warm and friendly and felt able to share concerns and address problems as a team.
• The practice was aware of the requirements of the duty of candour and systems were in place to ensure compliance with this.
• The practice was committed to continuous learning and improvement and actively sought feedback from staff and patients, as well as sharing learning with other organisations to promote good practice.

We saw two areas of outstanding practice:

• The practice had begun running its own screening program in 2003 with the aim of identifying patients at risk of a long term condition before they became symptomatic. The practice reviewed patients identified as being at risk at six monthly intervals to monitor their progress. As a result the practice was able to reduce the risk of these patients developing long term conditions. For example, of the patients identified as at risk of developing diabetes, over 50% were no longer at risk following the involvement of the practice.
• Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were higher than CCG and national averages, particularly excelling in breast and cervical cancer screening, childhood immunisations and all long term conditions. The patient population had high levels of social deprivation and cultural diversity which made it more challenging to engage patients with services. This made the practice’s high level of performance particularly significant when compared with averages in the local CCG area. The practice put a lot of effort into following up with patients who did not attend for screenings, examinations and treatments following invitation, and this work was often done by the senior GP outside of the practices opening hours.

The areas where the practice should make improvements are:

• Continue to monitor stocks of emergency medicines and carry out a risk assessment to ensure the medicines held are appropriate.
• Continue to review and encourage patient uptake of bowel cancer screening.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice