Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Walford Mill Medical Centre on 30 November 2016. Overall the practice is rated as good.

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

• Patients experienced flexible services that aimed to provide choice and continuity of care. The practice had a higher percentage of patients over 75 years compared with the national average and had developed services to meet their needs. Examples included individualised approach to triage by the patients own GP. Tracker nurses (carrying out home visits) working closely with GPs to support vulnerable patients resulting in a reduction of unplanned hospital admissions.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed. The practice was piloting an integrated multidisciplinary approach to monitoring vulnerable patients in the community.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. The practice reviewed its staffing requirements in line with changing patient demand. Staff were actively encouraged to develop their skills and had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• All 21 patients who gave feedback 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, 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.
• The provider was aware of and complied with the requirements of the duty of candour.

• The practice achieved high levels of performance with patient involvement about decisions of their care and treatment. For example, 98% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is better than the national average of 84%.

We saw one area of outstanding practice:

A pilot was underway for a new approach to triage patients under 16. This aimed to increase parent awareness of red flag symptoms requiring urgent assessment, such as a high fever and promotion of self management were appropriate.  Although in the early stages of the pilot, some positive outcomes were seen.  Records demonstrated the practice had identified parents needing additional support, had put this in place and were receiving prompt assessment and reassurance when their child was ill.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice