Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Winchcombe Medical Centre on 25 August 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 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 delivering health awareness advice in local schools and working mens clubs.
• The practice had initiated dometic violence training for staff. In order that a single patients best interest was always at the heart of an individuals care, in instances of domestic violence, the practice ensured wherever possible, that the abused patient and their spouse were consulted with by different GP’s, in order that confidence and confidentiality was maintained.
• Feedback from patients about their care was consistently positive.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. For example, the practice improved quality of care and improved outcomes for patients by working collaboratively with other stakeholders to reduce hospital admissions of frail elderly patients.
• The practice were proactive in identifying patients with atrial fibrillation (AF), resulting in a greater number of patients being effectively managed to prevent them having a stroke.
• 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice actively reviewed complaints and how they are managed and responded to, and made improvements as a result.
• 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 had strong and visible clinical and managerial leadership and governance arrangements.

We saw two areas of outstanding practice including:

• The practice had identified patients at risk of hospital admission and worked with the community team, for example the rapid response team to prevent hospital admissions. To reduce hospital referrals the practice recognised the expertise of the GPs within the practice and initiated an in house referral system. Data showed that this approach had resulted in the practice having lower than average, referral and admission rates compared to local practices with a similar demography.

• The practice had delivered, in collaboration with the PPG health awareness sessions on men’s health, at the local working men’s club and teenage health at the local secondary school. This had provided the opportunity to deliver health education advice to hard to access cohorts of the population, who were unlikely to attend the practice for health advice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice