Whaddon House Surgery Also known as whaddon medical centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Whaddon House Surgery on 2 August 2016. Overall the practice is rated as outstanding .

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, the practice had pioneered services to deliver point of care testing (POCT) for D-Dimer and BNP across the locality. (D-dimer tests are used to rule out the presence of a blood clot and BNP tests help with early diagnosis of heart failure).
• Services were tailored to meet the needs of individual patients and were delivered in a way to ensure flexibility, choice and continuity of care.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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, all patients suffering from COPD were invited to join the Milton Keynes Pulmonary Maintenance Group (a support group initiated by the respiratory lead GP at the practice). In addition the practice hosted the local ‘Breathe Easy Group’ meetings which provided support and educational talks for patients with COPD.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice employed an innovative use of technology to provide services to its patients.
• 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 with quality and safety as its top priority. High standards were promoted and owned by all practice staff and teams worked together across all roles.
• 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 several areas of outstanding practice including:

• The practice had invested considerably in the provision of the Community Cardiology service which had many positive outcomes for patients in the locality. For example, they had pioneered services to provide point of care testing (POCT) for Troponin T testing which was used for patients presenting with chest pain in the surgery. An audit demonstrated that up to 88% of potential emergency hospital admissions were avoided through the use of these tests.
• In collaboration with the PPG the practice facilitated regular patient education evenings led by a member of the clinical team or a guest speaker. These sessions were used as an opportunity to provide information on a range of general health topics as well as dedicated evenings for specific groups. The practice demonstrated a commitment to supporting vulnerable patients in their population, developing initiatives with the support of the PPG to work compassionately with patients who may be isolated. For example, in 2013, with the support of the local Community Safety Officer and the PPG, the practice had developed a group known as ‘Living in the Moment’, focused on reaching out to patients who may have become isolated.
• The practice had purchased a number of Sleep Apnoea testing monitors to support patients presenting with sleep problems. Monitors were fitted by trained health care assistants and patients returned the following day to see the GP for results to be analysed. If required the patient would be referred on to the Oxford Sleep Clinic for further investigations. Providing testing in house reduced the need for patients to be seen in secondary care locally before referral to a specialist facility in Oxford. The practice demonstrated a reduction in referrals of 70% for the period May 2014 to July 2016. Patients not referred received further support from the practice to ascertain and treat the underlying causes of their sleep difficulties, for example, poor chronic disease management.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice