Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Tong Medical Practice on 19 February 2015. Overall the practice is rated as outstanding.

Specifically, we found the practice to be outstanding for providing effective, caring and responsive services. We found them to be good for providing safe and well led services. It was also rated as outstanding for all the population groups.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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 was available and easy to understand.
• Patients said they found it easy to make an appointment, 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 saw areas of outstanding practice as follows:

• There was outstanding and innovative practice for management, monitoring and improving outcomes for people.

• The practice completed detailed monthly performance reports to monitor their effectiveness against quality and prescribing targets and areas for improvements to practice were shared with all clinical staff. National data showed the practice performed well and provided good and improving outcomes for patients.

• There was outstanding practice in health promotion and prevention.

• The practice provided a “one stop shop” for patients to access health and community services. To achieve this, the practice worked very closely with other health professionals and community and voluntary services and they were focused on using every opportunity for health promotion. A community interest company, Healthy Lifestyle, had been initiated at the practice. Additional clinics and services were available for patients within the practice. These included provision of physiotherapy, podiatry, audiology, retinal screening, benefits advice, substance misuse and alcohol services and psychological therapies. A wide range of information was available for patients in the practice and on the web site.

• There was outstanding and innovative practice in supporting patients to cope emotionally with care and treatment.

• The practice had a dedicated member of staff in a patient liaison role. Their role included working with the patient participation group (PPG) and the community interest company (CIC) to improve services for patients. We received a number of very positive comments from patients who told us about this member of staff and their work. They were described as a miracle worker by patients due to their ability to support patients and assist them with their health and social care needs. Patients also told us they felt the practice was very good at signposting them to services offering support and the practice had initiated support groups for patients.

• There was outstanding and innovative practice in responding to people’s needs

• One GP used their specific interest in mental health to improve care for patients with mental ill health and learning disability. This GP provided extended appointments for seriously mentally ill (SMI) patients and acted as resource for other clinicians. They had worked on schemes within the practice to improve the care for people with mental ill health such as provision of behavioural activation therapy and liaison Psychiatry services.
• Specifically designed services for teenagers had been developed called Tong Teen Choice. This was a drop in service provided at the practice and the local school for teenagers to discuss any health concerns they may have. This had encouraged teenagers to seek health advice and the practice had been able to support and safeguard children through this service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice