Archived: Whitehouse Centre GP Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Whitehouse Centre on 26 May 2016. Overall the practice is rated as outstanding. The practice provides services for patients who find it difficult to access mainstream services because of complex circumstances. Patients are mainly asylum seekers, homeless or living in emergency accommodation.

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 practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, developing effective and responsive shared care treatment pathways for patients receiving treatment for substance misuse.

• Feedback from patients about their care was consistently positive.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. For example, in the anticipation of high levels of asylum seekers entering the district, the provider had developed a standard operating procedure. This was to ensure the safe dispersal of patients into mainstream services after an annual review, with safeguards to retain patients on the list if indicated.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients. For example, providing flexible appointment access for clearly identified and risk assessed patients who were unable to attend fixed appointment slots due to their complex psychological or physical difficulties.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice actively reviewed complaints and how they are managed and responded to, and made improvements as a result.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.

• The provider was aware of and complied with the requirements of the duty of candour.

We saw a number of areas of outstanding practice:

• New adult patients were screened for their exposure to trauma including post traumatic stress disorder (PTSD) and its impact on mental health. The clinical team had expertise in identifying victims of torture and had developed a clinical template to aid assessment and a suitable treatment plan.

• Clinical meetings were held on a daily basis, ensuring that all staff were kept informed of patients’ needs, clinical decision making and operational issues that might impact on patient care. This approach encouraged the sharing of expertise and promoted a strong sense of teamwork.

• The practice ethos was underpinned by compassion that extended to providing social assistance for the homeless, such as food parcels, clothing and discretionary funding to provide taxis for those that would otherwise be unable to access services.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice