Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Trinity Medical Centre on 14 July 2016. Overall the practice is rated as good.

Our key findings were as follows:

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
• 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 and how to complain was available and easy to understand.
• Patients said they were able to get an appointment with a GP when they needed one, 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 in place and staff felt supported by management. The practice proactively sought feedback from staff and patients, which they acted on.

• Staff throughout the practice worked well together as a team.

• The practice proactively sought feedback from patients. Patients were involved in the review of complaints; anonymised details of complaints were shared with the patient participation group (PPG).

We saw several areas of outstanding practice including:

• The practice had developed an ‘older population clinic’. Clinics had been held monthly since December 2015. The clinics were aimed at all patients over the age of 65, including housebound patients. Patients were invited in for a two and a half hour appointment; which included a full health check with a nurse, then a medication review with a GP, this time was also used for the patient to have time to talk about any concerns they may have had. The practice worked with a charity to arrange for a minibus to collect housebound patients and take them home again after their appointment.

• One of the receptionists was the ‘young person champion’; they were a point of contact for any young patients who needed advice on which service to access. The practice wrote to all registered patients when they reached 14 years of age. A newsletter specifically designed for young people was included; this gave information about how to use the surgery, what their rights were, an explanation about confidentiality and had links to various health related ‘apps’ for mobile devices. The practice website had a dedicated section for young people.

• The practice used new technologies to engage with patients. This included the use of ‘facetime’ to carry out consultations; when the nurses carried out visits to housebound patients they used a tablet device to allow the patient to communicate with the GP back at the surgery. This allowed for medication reviews to be carried out at the same time as health checks, and enabled staff carrying out the home visit to access patients’ full medical records. At the time of the inspection the practice was actively reviewing a web cam based system which would link directly into the clinical records system.

The areas where the provider should make improvements are:

• Take steps to ensure all recommendations in the recent legionella risk assessment are actioned.

• Take steps to ensure staff are aware of any necessary action to be taken following receipt of national patient safety alerts.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice