Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Wells Health Centre partnership on Wednesday 9 November 2016. Overall the practice is rated as good.

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

• 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.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

• The practice provided daily GP services to up to 300 male and female boarders at the nearby Wells Cathedral School.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• The practice employed a clinical pharmacist to identify and act upon high risk medicines, oversee prescribing patterns, review patients who were taking 10 or more medicines, review post discharge medicines and support long term condition management.

• 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 GP and said there were urgent appointments available the same day but added that they sometimes had to wait to see a GP of their choice.

• E consultations (on line consultations) were available and acted upon promptly.

• The practice promoted sepsis assessments and used management guidelines for GPs and parents to identify sepsis.

• Wells Health Centre offered the ‘C card’ service. (The C Card scheme is where practices offer easy, discreet and confidential access to free condoms for young adults).

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• The practice proactively identified carers within the practice patient list and signposted patients to services and provided written information.

• The practice sent a letter to all teenagers following their 16th Birthday providing information about the practice and an opportunity to update clinical records, offer online access to records and establish connection with those who need support.

• 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.

We saw one area of outstanding practice:

The practice promoted ‘health and wellbeing reviews’ at the practice. This model of care involved an hours appointment with a health coach who reviewed and scored five aspects (human 5) of the patients life and used nationally recognised tools to assess the patients wellbeing, patient awareness and loneliness. The patient then met with the GP for a 30 minute appointment to ensure the medical care was person-centred and individually tailored. The model had resulted in patients experiencing increased wellbeing, health and a reduction in medicine usage. For example, one patient was dependent upon medicines, was unemployed, a frequent attender at the practice and had multiple  hospital admissions. They had gone through the review process and as a result had requested to reduce their medicine use, demonstrated improved wellbeing and was planning voluntary work. Data showed that 30 patients had started the programme since September. Of the 12 patients on stage two of the course, eight had reduced the numbers of medicines being taken.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice