Regent Medical Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Regent Medical Centre on 10 January 2017. Overall, the practice is rated as good.

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

• Staff understood their responsibilities to raise concerns and report incidents and near misses to the practice manager.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• 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.
• Results for the National GP Survey, published in July 2016, were above local and national averages access to services. For example, for those that responded, 96% found it easy to get thorough to the surgery by phone (CCG average 79%, national average 73%).
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice had a clear vision and strategy that all members of staff were involved in reviewing and developing.
• 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 regulation.

We saw four areas of outstanding practice:

• Feedback from patients and carers we spoke to was continually positive about the way that staff treated people. Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment. We saw a strong patient-centred culture. We heard of many examples where staff had gone the extra mile, for example delivering prescriptions when patients were unable to collect prescriptions, seeing patients outside normal clinical session times and taking steps to ensure vulnerable patients, such as patients with learning disabilities, had continuity of care.
• Data showed that patients rated the practice higher than others for several aspects of care. According to the latest National GP Patient Survey results, 81% of respondents said they usually get to see their preferred GP (CCG average 61%, national average 59%). Data from the most recent Friends and Family Survey carried out by the practice, from September 2016 to November 2016, showed that 100% of patients said they would be extremely likely or likely to recommend the service to family and friends.
• The practice introduced a review of patients with long-term conditions who did not attend for review appointments into their monthly clinical meeting following an incident. Following a whole team discussion, each non-attender was proactively followed up. Since this review was introduced 73% of the patients discussed had been subsequently seen by a clinician for a review of their chronic disease. The practice planned a formal audit of this work when it had been in place for 12 months.
• The practice had worked to improve the outcomes for patients. For example, monthly unplanned admission meetings had been introduced as part of a local CCG project; this meeting included attached staff such as district nurses and the community matron. At these meetings, patients were discussed and comprehensive care plans were developed when required. A review of data showed that for 2015, 18% of these admissions had been deemed as avoidable, for 2016, only 4% of these admissions had been deemed avoidable. In addition the practice had introduced the palliative care ‘Gold Standards Framework’. As part of this, they had completed work to increase the identification of patients on their palliative care register over the last 12 months. This had resulted in an increase from 9.5% to 44% of patients on this register because of a diagnosis other than cancer. This encouraged the discussion about all patients requiring end of life care at the monthly multi-disciplinary team (MDT) meetings.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice