This practice is rated as outstanding overall. (Previous rating March 2015 – Good)
The key questions at this inspection are rated as:
Are services safe? – Good
Are services effective? – Outstanding
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Outstanding
We carried out an announced comprehensive inspection at Lion Health on 2 July 2018 as part of our inspection programme.
At this inspection we found:
• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access same day care when they needed it. However, patient feedback on telephone access was generally negative.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
We saw areas of outstanding practice:
• The practice had a dedicated advanced nurse practitioner (ANP) for patients in care homes and acutely unwell patients.
• The practice had adopted an ‘assertive outreach’ strategy to improve the uptake of long-term condition clinics. This involved proactively reaching out to patients based on clinical need; for example, online monitoring for working age people.
• When patients were assessed to be at risk of suicide or self-harm the practice had arrangements in place to help them to remain safe. The practice took a proactive approach to reduce suicide cases by holding an educational event with an external speaker and had internally reviewed cases to identify any learning.
• There was an extensive programme of governance meetings that included all staff and extended to a wide range of healthcare professionals. The programme of multidisciplinary team meetings (MDT) included dedicated time set aside from the main MDT meeting to discuss and review the care and treatment for palliative patients, patients with poor mental health and patients with respiratory conditions. As an example of good practice, the local CCG shared learning from this practice model with other practices within the CCG and had been used as a demonstrator site for other CCGs.
• The practice had developed their approach for managing patients with long-term conditions with the introduction of a dedicated administrative team and a patient centred approach to improving attendances for reviews. The non-attendance rate and the average attendance rate had both halved since 2016 and 80% of patients with a long-term condition had all components reviewed at one appointment. The percentage of patients on each long-term register who had received at least annual reviews was consistently high. The practice had written their own protocols for long-term condition management that provided comprehensive and effective treatment and care.
The areas where the provider should make improvements are:
• Ensure that the new telephone system improves access for patients.
Professor Steve Field CBE FRCP FFPH FRCGP