Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Olive Family Practice Ltd on 27 May 2016. Overall the practice is rated as outstanding.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.

• The practice used innovative and proactive methods to improve patient outcomes. For example, they did not have set appointment times and instead had devised a system using units of activity. This worked well due to the diverse needs of the patients, where interpreters were often required and often patients had complex needs.

• Feedback from patients about their care was consistently positive.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. For example there was close contact with the local mosques.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice actively reviewed complaints and how they were managed and responded to.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.

We saw several areas of outstanding practice including:

• The practice had good links with the local mosques.

• GPs usually looked after the palliative care needs of their patients, and where it was anticipated they would be away from the practice another GP in the area was introduced to the family in advance to ensure continuity of care. GPs were contacted by religious leaders or families when a death occurred and they attended in a timely manner to issue death certificates so a funeral could be arranged according to the patient’s religious beliefs.

• Information within the practice was available in a variety of languages and staff also spoke several languages. The practice had established links with a nearby community centre that could provide translation services as some of the languages spoken by patients were not covered by the telephone translation service. For example, volunteers translated for the Oromo language. There were over 20 languages spoken by patients at the practice and a high proportion did not speak English as a first language so interpreters were required daily.

• The practice had a flexible appointments system, so instead of having set appointments they had units of activity in five minute blocks. They found this met the needs of the diverse practice population and reception staff had been well trained in how to determine the appropriate number of units of activity to allocate to a patient. For example, if translation services were required a patient was usually allocated 20 minutes, and five minutes was allocated to a telephone appointment. We saw an example of a non-English speaking patient with post-traumatic stress disorder being allocated 50 minutes.

• In response to demand during the winter months the practice had a walk-in surgery for a short time in the afternoons. They still directed patients to the pharmacy if this was appropriate but they found the open surgery was the most effective way of managing the needs of the patients and the time of the clinical and reception staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice