This practice is rated as good overall. At the previous inspection in October 2015 the practice was rated as outstanding overall; with an outstanding rating achieved for responsive and well-led services and a good rating achieved for safe, effective and caring.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at University of East Anglia Medical Centre on 7 September 2018.

At this inspection we found:

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided and worked with the university to ensure that care and treatment were provided at the most appropriate times. It ensured that care and treatment was delivered according to evidence-based guidelines.
• The practice’s performance in relation to the Quality Outcome Framework (QOF) results was generally in line with the Clinical Commissioning Group (CCG) and national averages.
• The practice had a programme of quality improvement activity planned and we saw evidence of a two-cycle audit completed which positively impacted on the quality of patient care.
• The practice had been operating a Norfolk and Suffolk Foundation Trust and University of East Anglia Medical Centre pilot for the placement of a mental health specialist nurse providing one session a week at the practice for approximately one year.
• Results from the July 2017 national GP patient survey were generally above local and national averages.
• The practice had initiated positive service improvements for its patients that were over and above its contractual obligations. It acted on suggestions for improvements and changed the way it delivered services in response to feedback from patients and the patient participation group (PPG).
• We saw evidence that complaints and significant events were handled effectively, trends were analysed and lessons learned and distributed amongst relevant staff.
• The practice actively reviewed the needs of its population and worked directly with the university to respond to patient needs and demand; the practice ensured that clinics were held at the correct time.
• The practice offered intuitive online services such as online registration that automatically notified the practice of existing long-term conditions and a website which translated into over 100 different languages to meet the need of the diverse student population.
• The leadership, governance and culture were used to drive and improve the delivery of high-quality person-centred care.
• There were high levels of staff and patient satisfaction. Staff were proud of the organisation as a place to work and spoke highly of the culture and morale.
• There were consistently high levels of constructive staff, patient and external stakeholder engagement.

The areas where the provider should make improvements are:

• Review and improve the uptake of cervical screening.
• Review and improve Quality Outcomes Framework exception reporting for Diabetes.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at University East Anglia medical centre on 1 September 2015. 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, working with other local providers to share best practice. For example patients that had returned from abroad with a potentially infectious disease could be cared for by liaising with local university services to isolate the patient if necessary in order to protect the public.

• Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment. Information was provided to help patients understand the care available to them.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure they met peoples’ needs.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the Patient Participation Group (PPG).
• The practice had purpose built facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand
• The practice had a clear vision which had quality and safety as its top priority. A business plan was in place, which was monitored, regularly reviewed and discussed with all staff. High standards were promoted and owned by all the practice staff. There was evidence of team working across all staff roles.
• The practice had created an electronic process to ensure that patients’ test results were dealt with efficiently. This innovative method provided a second check on results and provided enhanced patient safety.

We saw several areas of outstanding practice including:

• The practice had reached out to the local community by working closely with university faculties, Dean of students office, and providing information and talks to student groups.

  The practice clinicians had attended these organisations and promoted better health. If any underlying health issues were identified the patients (if they belonged to the practice) were offered an appointment at the practice and patients from other practices were advised to attend their own GP.

• The practice had an assessment facility within the building. Patients with health concerns and with a limited support mechanism at home could be cared for at the practice until it was safe for them to return home. GPs made arrangements for patients to be supported when the practice closed at the end of the day.
• The practice had developed a high level of clinical and administrative leadership and practice solutions. These were shared with and utilised by other practices, this was particularly in relation to contraception and by their involvement in caring for patients with eating disorders and mental health.

• The practice population had a high prevalence of patients suffering from eating disorders (approximately 25% of total patients across the whole CCG of 22 practices). The practice had greatly enhanced its response to these patients by utilising a dedicated administrator who made sure all patients were followed up correctly. The practice employed effective inter agency working in order to provide the best on-going support to this patient group. They provided clinical support to the University Dean and worked together in the patients’ interests.

• The practice engaged with a programme for the orientation of international patients. With 65% of the practice population being students and 43% of their total patients being born overseas, this programme educated students about NHS services, including managing expectations, immunisations, sexual health and general well-being.
• We saw an innovative method of maintaining confidentiality in reception. The GPs had developed a list of 33 common conditions that patients presented with. These were advertised in reception on the desk and patients read the number out to the receptionist rather than verbally outlining their condition. This assisted the patient to keep their condition confidential if they wished to do so.

However there were areas of practice where the provider should make improvements:

Importantly the provider should;

Review the contents of their emergency drugs kit to ensure that they are appropriate for all anticipated emergencies.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice