Norwood Medical Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Norwood Medical Practice on 18 November 2015. 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 NHS National GP Patient Survey of the practice showed high levels of patient satisfaction with the quality of GP and nurse consultations.
• Staff were committed to supporting patients to live healthier lives through a targeted and very proactive approach to health promotion.
• Risks to patients and staff were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• The practice was well equipped to treat patients and meet their needs.

• All staff were actively engaged in activities to monitor and improve quality and outcomes for patients.

• Information about how to complain was available and easy to understand.
• Very good arrangements had been made to meet the needs of patients who were also carers.
• Patient feedback about access to the practice and appointments was mixed. Whilst some patients were satisfied with access, the NHS GP Patient Survey results showed lower levels of satisfaction than the local Clinical Commissioning Group and national averages. The practice had taken steps to address this by making changes to their appointment system and how they met patients’ needs.
• The leadership, governance and culture at the practice were used to drive and improve the delivery of high-quality person-centred care. There was a clear leadership structure and staff felt supported by the management team. Very good governance arrangements were in place.
• The practice had a clear vision for the development of the practice and safety as its top priority. The strategy and supporting objectives were stretching and challenging, whilst remaining achievable. Staff were committed to providing their patients with good quality care.

We also saw areas of outstanding practice:

• There were very good arrangements for meeting the needs of patients who required dermatological care and treatment. The senior GP partner acted as a GP with a Special Interest, and had set up a local community dermatology clinic at the practice. 220 patients had received care and treatment at the clinic during 2014/15. All patients, including those not registered with the practice, were seen and treated within three weeks of being referred to the clinic. Of these 514 patients, 53 had been diagnosed with skin cancer and, where relevant, an appropriate referral had been made to specialist services. This is outstanding because the practice is providing an additional service which reduces the burden on hospital services and enables patients to receive care and treatment closer to home.  
• The practice demonstrated a very caring and responsive approach to patients and their individual needs. They had a dedicated member of staff in a patient liaison adviser (PLA) role, who was available, at all times the practice was open, to offer practical and emotional support to patients, and to advocate on their behalf with other agencies and support groups. On average, the PLA provided assistance to at least two patients every week. This is outstanding because it showed a strong commitment to helping patients who are facing emotional and practical challenges in their lives.
• Overall, there were very good arrangements for meeting the needs of patients diagnosed with dementia. The practice had designated clinical dementia leads who had worked with the rest of the team to improve their performance regarding the early diagnosis of dementia. Patients identified as being at risk of developing dementia were contacted by telephone and invited to make an appointment for their annual health care review. Where clinical staff had concerns about a patient’s memory, allocated memory clinic appointments were also available at the practice. Clinicians were proactive in caring out dementia screening, where they thought patients were at risk of developing dementia. Several members of staff had completed the ‘Dementia Friends’ training course, to help them provide dementia patients with appropriate care and support.

However, there were also areas where the provider needs to make improvements. The provider should:

• GPs should carry emergency medicines for use on home visits in acute situations.
• Continue to review and improve the practice’s telephone access and appointment system.
• Ensure that the guidance issued by NHS Protect regarding prescription security is followed.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice