Archived: South Molton Health Centre

Letter from the Chief Inspector of General Practice

South Molton Health Centre was inspected on Tuesday 4 November 2014. This was a comprehensive inspection.

This practice provides primary medical services to people living in the North Devon town of South Molton and the surrounding areas. It provides services to a diverse population age group and is situated in the heart of the town.

Five GP partners and a retained GP make up full time equivalent of 3.65 GPs which provides cover for approximately 5,500 registered patients. A mix of services is provided in addition to core services, including carers’ health checks. Patients who use the practice have access to community staff including district nurses, community psychiatric nurses, health visitors, physiotherapists, mental health staff, counsellors, chiropodist and midwives.

We found this practice promoted safe working practices energetically and systematically and was very responsive to patients’ needs. We found the practice was effective, caring and well led.

Our key findings were as follows:

Patients told us they had found staff to be helpful, kind, caring and patient. Four patients said their care had been excellent. Patients told us that their GP listened to their problems, explained treatment options so they could understand and treated them with dignity and respect.

Patients said that this service had not made assumptions about people, or ‘pigeon-holed’ them. They said the GPs and staff would expand a service in order to fit a person in, if necessary. There were systems in place, but variations could be made for individual’s welfare. Patients said the positive relationships observed within the team gave them confidence and made them feel comfortable.

A duty system had been introduced. There was a GP each day to deal with urgent appointments during normal opening hours. There were also some same day non-urgent slots available. Patients told us it was a good system and that staff were prepared to flex it to accommodate a patient.

Nurses ran clinics for patients with coronary heart disease, asthma, chronic obstructive pulmonary disease (COPD), hypertension and diabetes. This recognised the needs of the locality. They followed up blood test results and any patients who did not attend to ensure they received essential treatment.

Infection prevention and control (IPC) was actively monitored throughout the practice. Progress was checked at monthly intervals at the Quality Group meeting. Achievement was recorded every month, with a different aspect of IPC promoted across the practice.

Good communication was maintained to provide good outcomes for patients. Practice nurses told us they were in regular communication with district nurses about the patients that they both treated.

The management team had developed a set of core competencies to outline expected standards of behaviour across the whole practice, for partners and staff. There was a clear leadership structure with named members of staff in lead roles and all the staff who spoke with us were clear about their own roles and responsibilities.

We saw outstanding practice including:

There was a reliable and proactive method for maintaining safe working practice. The Quality Group met bi-monthly to monitor progress and included a GP partner, a staff representative, the practice manager, deputy practice manager and lead nurse. All matters to do with any aspect of patient safety identified by any staff member were entered on the risk register, which was seen to be a working document. At each meeting, new concerns and progress with old ones were discussed, focussing on items that team leaders were actively promoting. The spreadsheet was updated each month and the current version made available for staff input over the next month. This provided a reliable and proactive way of assessing risk and taking action effectively across the whole practice to provide a safe service.

The practice joined in an annual outreach event in town hall with local voluntary groups providing health promotion, lifestyle advice and health checks. This year the event was entitled ‘Ageing Well’. The practice took care to offer flexibility with appointments to enable people who could not drive, to access services, where public transport was limited to one bus per week. Staff arranged for prescriptions to be signed on the day to avoid the need for a repeat journey.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice