Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Trinity Medical Practice on 1 September 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 within the practice. Effective systems were in place to report, record and learn from significant events. Learning was shared with staff and external stakeholders where appropriate.

• Feedback from patients about their care was consistently positive and was significantly above the local and national averages.

• There were established and embedded processes in place for managing medicines.

• Effective standards of cleanliness and hygiene were maintained throughout the practice.

• The practice had a system in place to ensure enough staff with the right skill mix were on duty to ensure safe care delivery.

• Bookable 10-minute appointments for patients who found it stressful to wait in a busy surgery were available from 12pm to 1pm daily and reserved for identified patients.

• Staff had received appropriate training to undertake their roles and responsibilities.

• The practice was approved for postgraduate medical education at Anglia Ruskin University, offering mentorship and supervision for those undertaking the medical prescribing course.

• The practice recognised the importance of the continuing development of staff skills, competence and knowledge to ensure high-quality care.

• The practice provided a highly responsive service to meet the needs of their patients across all population groups and tailored them accordingly.

• The practice held several different meetings with health care professionals to share and coordinate services for patients.

• Staff understood the relevant consent and decision-making requirements of legislation and guidance.

• The practice proactively offered residents and people holidaying in local caravan parks, the opportunity to register at the practice to receive care and treatment when required.

• Staff used every contact as an opportunity to identify potential risks to patients health and signposted them to support to live healthier lives.

• There was a strong, visible, person-centred culture within the practice. Staff were highly motivated to offer care that was kind and promoted patient’s dignity.

• Information about services and how to complain was available and easy to understand.

• The practice had a clear vision and a set of values, with patient’s wellbeing as a priority.

• There was a clear leadership structure and staff felt supported by management.

• The practice actively sought the views from a wide range of stakeholders, including patients, staff, visiting professionals and commissioners about their experience of and quality of care and treatment delivered.

We saw several areas of outstanding practice:

• The practice recognised the risk to patients suffering from poor mental health, who did not collect their prescriptions. They had put a system in place to issue prescriptions on a weekly basis only for early detection of crisis. The practice had promoted itself as a place of safety for any person who felt vulnerable or in need. They advertised through the community press outlining its purpose, and a logo was displayed in the practice front window.
• The practice’s computer system alerted GPs if a patient was also a carer. The practice had identified 4.5% of the practice list as carers. There were processes in place that alerted the GP if a carer had been admitted to hospital. There were plans in place to ensure the frail patient left at home would receive support. For these cases there was close liaison with the carer and the family of the patient so that alternative arrangements could be made to ensure there was continuity of care for the patient concerned.
• The practice had built a close liaison with the local school. They offered a minor injuries service where an injured child could attend the surgery for immediate triage and assessment. This resulted in a reduced A&E attendances and was less stressful for parent and child as they were seen in a familiar environment. The local school has a number of children identified with special educational needs; these children often have complex medical needs also. The GP liaises with the school to attend joint review meeting to establish timely interventions and resolution of issues.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice