Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Wolstanton Medical Centre on 1 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 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. They worked with other local providers to share best practice. For example, the cleansing of non-surgical wounds with tap water rather than sterile water. A report had been presented to the local Clinical Commissioning Group (CCG) highlighting the benefits to patients and the health economy to influence and change local practices.

• 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 met patients’ needs. For example, the practice provided a shared care maintenance programme for patients with opioid addiction.

• 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. For example, the practice had added three additional telephone lines to reduce the waiting time for the telephone to be answered.

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

• The practice actively reviewed complaints and how they were managed and responded to, and made improvements as a result.

• The practice had a clear vision which had quality and compassion as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed.

• The practice had strong and visible clinical and managerial leadership and governance arrangements.

We saw three areas of outstanding practice:

• The practice went beyond the scope of normal support and development of their staff. For example, three GPs had been supported to study for a Doctor of Philosophy (a doctorate degree awarded by universities) and an Advanced Nurse Practitioner (ANP) had been supported by the practice to take on leadership roles within and outside of the practice.

• Patients over 75 years old were provided with a questionnaire to identify any medical or social needs. Seven hundred and seventy-nine questionnaires had been sent out to patients of which 701 were returned. Of these, 221 patients had identified needs and were assessed by the complex needs nurse and appropriate care and referrals were made to support these patients.

• The practice was not only proactive in managing, monitoring and improving outcomes for its own patients but it shared its learning locally and nationally within primary care. It did this by contributing to reports to the CCG such as the benefits to the health economy through the use of tap water rather than sterile water in the cleansing of non-surgical wounds. They had also published their research in recognised medical journals, for example, the diagnosis of Addison’s disease (a rare, chronic disorder in which insufficient steroid hormones are produced).

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

• Ensure there is a system in place to record and monitor all prescription pads received into the practice.

• Ensure blank prescription forms are stored securely in locked rooms at all times.

• Ensure regular fire drills are carried out.

• Ensure that targeted services are in place to support carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice