Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Woodlands Medical Practice on 13 October 2016. Overall the practice is rated as outstanding.

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

• There was an effective system in place for reporting and recording significant events and learning was shared with all staff in meetings.

• Risks to patients were assessed and well managed.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.

• Patient survey figures were consistently above average when compared with CCG and national averages.

• Comments about the practice and staff were wholly positive.

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

• Information about how to complain was available and easy to understand, and the practice responded quickly when issues were raised. Learning from complaints was shared with staff and other stakeholders.

• 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. We saw this to be the case on the day of inspection.

• 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 offered extended hours so that appointments could be made up from 7.15am on a Tuesday and Friday morning for patients that worked and could not attend during normal opening hours. These appointments were reserved for working patients but were released to the other patients if they had not been booked the day before.

• Safety alerts and alerts from Medicines and Healthcare products Regulatory Agency (MHRA) were reviewed and cascaded to the appropriate persons. The practice had a log of the alerts received which showed the title of the alert and the members of staff that it had been passed to. It also showed actions taken, for example searches on records and patients contacted were necessary.

• The practice had clearly defined and embedded systems, processes and practices in place to keep patients safe and safeguarded from abuse.

• Governance and performance management arrangements had been proactively reviewed and took account of current models of best practice. There was an overarching governance framework which supported the delivery of the strategy and good quality care. This included arrangements to monitor and improve quality and identify risk.

• There was a comprehensive understanding of the performance of the practice and individuals within the team.

We saw areas of outstanding practice including

• The practice took the care of vulnerable people seriously. For example, patients with learning disabilities were managed alongside the primary care liaison nurse for learning disabilities. The practice was proactive in identifying patients including those that reached the eligible age to be an adult with a learning disability. Over 90% of eligible health checks were completed which was achieved by sending pictorial leaflets to patients explaining the health check and liaison with the primary care liaison nurse regarding non attenders or non responders. Carers were supported in the practice. The practice had a carers champion and the practice had had identified 471 patients as carers (4.9% of the practice list). The practice computer system also alerted staff if patients had a carer. The practice had 371 patients that had been identified as having a carer (3.8% of the practice list). These patients would be contacted by the carers champion to see what support could be offered. The practice contacted external agencies to assist with supporting carers for example for families of palliative patients at times to arrange services such as night sitting to alleviate the pressures of carers and had received an award in 2016 from the CCG for going the extra mile.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice