Letter from the Chief Inspector of General Practice
We carried out a comprehensive inspection of Cuckoo Lane Practice on 28 January 2015. Overall the practice is rated as outstanding.
Specifically, we found the practice to be outstanding for being well-led and providing responsive and effective services. We found they were good for providing safe and caring services. It was also outstanding for the care provided to older people, people with long term conditions, families, children and young people, people living in vulnerable circumstances and people experiencing poor mental health (including people with dementia). They were good for the care and treatment they offered working aged people (including those recently retired) and people whose circumstances make them vulnerable.
Our key findings were as follows:
- Arrangements were in place to ensure patients were kept safe. The practice learnt when things went wrong and shared learning with all staff to minimise the risk of reoccurrence
- Patients’ needs were appropriately assessed and care and treatment was delivered in line with current legislation and best practice.
- We saw from our observations and heard from patients that they were treated with dignity and respect.
- The practice understood the needs of their patients and provided services that met their needs.
- The practice was well-led, had a defined leadership structure and staff felt supported in their roles.
We saw areas of outstanding practice including:
- One nurse practitioner at the practice carried out spirometry tests and also provided a weekly clinic for patients registered at other local practices. All COPD patients are given a self-management plan with particular reference to rescue medication. This has led improved symptom control and less hospital admissions for 25% of patients in this group over the last year.
- The practice took part in the ‘shifting settings of care’ program which supported patients with mental illness access better, more integrated care outside of hospital and transfer the care of people with ‘common mental illness’ or stable ‘severe and enduring mental illness’ from mental health services into primary care. One impact being 19 patients who would have previously received care in Secondary care setting in the past are now receiving their support and treatment from their GP surgery.
- An example of integrated care for older people is that an Age UK support worker attended the practice three days a week, to support older patients who live on their own. The practice also provided transport to improve access for those patients who are house bound or find it difficult to get to the surgery. Patients reported satisfaction and liked being able to attend the surgery. This improves socialisation and reduced the amount of home visits by 20 during its first month.
- The practice was instrumental in establishing an Ealing wide approach to the three tier model of shared care for diabetes. This pilot project was part of a major redesign of diabetes care across Ealing and led to more diabetic nurse specialist being appointed including a Diabetic nurse consultant for the borough and weekly satellite clinics.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice