Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at West Hallam Medical Centre on 28 June 2016. 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. All opportunities for learning from incidents were maximised.

• Risks to patients were assessed and well managed.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Clinical audit drove quality improvement in all areas of activity. Staff had the skills, knowledge and experience to deliver effective care and treatment.

• Resources were deployed to ensure individual patient healthcare needs were optimised. Data showed that the practice was performing highly when compared to practices nationally.

• Patient feedback regarding care and treatment received was consistently positive.

• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. The practice was involved in a new ways of working project, aimed at maximising GP time and efficiency.
• The practice had strong and visible clinical and managerial leadership and governance arrangements. Staff were passionate about their roles and responsibilities, they felt valued within the practice and feedback regarding leadership was consistently positive.

We saw areas of outstanding practice including:

Data which included Quality and Outcomes Framework (QOF) showed the practice consistently achieved high results across the areas of practice. These included those with long term conditions, older people and patients who had a learning disability. The practice did not exception report in some areas of practice or it was low when compared to CCG and national averages.

The practice proactively engaged with their patient population and understood their individual needs and requirements. This was demonstrated in quality monitoring activities such as a mental health audit and the identification of a large number of patients who had carers responsibilities.

The practice had introduced a new model of care in the delivery of its services which represented a move away from traditional GP led care. Staff with specialist skills had been recruited or upskilled within the practice. Patient health care needs were optimised by alignment with staff skill set and expertise. Patients, including those with long term conditions had benefitted from this new model of working and outcomes were evident. These included an increase in reviews being undertaken in 2015/16 for those patients with long term conditions.

Data showed that the practice’s emergency hospital admissions had continually decreased from March 2013 to February 2016. The practice had the lowest number of emergency admissions by locality across 18 practices within the CCG.

The practice worked in collaboration with four local practices on a project to drive improvement in care for older people and reduce emergency admissions from care homes. This had resulted in an 8% reduction in emergency admissions in the preceding 12 months.

However there was an area of practice where the provider should make improvement:

• Consider whether dispensing ‘near misses’ should be recorded and a system put in place to learn lessons from these events.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice