Letter from the Chief Inspector of General Practice
This practice is rated as Good overall, but is rated as requires improvement for providing caring services. (The previous inspection was carried out on 4 November 2014 and the practice was rated as Good.)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Requires improvement
Are services responsive? – Good
Are services well-led? - Good
As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:
Older People – Good
People with long-term conditions – Good
Families, children and young people – Good
Working age people (including those retired and students – Good
People whose circumstances may make them vulnerable – Good
People experiencing poor mental health (including people with dementia) - Good
We carried out an announced comprehensive inspection at Little Horton Lane Medical Centre - Mall on 13 December 2017 as part of our inspection programme.
At this inspection we found:
- The practice had clear systems and protocols to review and manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
- There was an embedded system in place for actioning and cascading medicine safety alerts.
- The partners in the practice routinely reviewed the effectiveness and appropriateness of the care they provided by a process of peer review and keeping themselves up to date with best practice. This ensured care and treatment was delivered according to evidence- based guidelines.
- We saw that staff treated patients with kindness. However, results from the July 2017 annual national GP patient survey found that patients did not feel they were always treated with compassion, dignity and respect.
- Patient satisfaction with access to appointments was comparable to the local clinical commissioning group (CCG) averages but below national averages. The practice were aware of this and had conducted their own survey between April and July of 2017. We saw that urgent appointments with GPs were available on the day of inspection.
- The practice had identified that some pregnant women were not referring themselves as expected to midwifery services following their initial confirmation of pregnancy. Therefore, all pregnant women were proactively referred directly to midwifery services by the clinicians at the practice.
- The practice had commenced a review of the immunisation status of the staff team; in line with the guidance ‘Immunisation against infectious disease’ (‘The Green Book’ updated 2014.) However, this had not been fully completed on the day of inspection.
- The practice had approached a local branch of a national children’s charity and from January 2018 had firm plans in place to begin working with them. The practice planned to hold workshops and talks and hoped to engage young people with the practice and in the patient participation group (PPG).
- We saw that the practice struggled to maintain a functioning Patient Participation Group (PPG) but were taking all necessary steps to support this.
- The practice were keen to engage with the wider community. They held charity events and regularly collected food items for local food banks.
We saw one area of outstanding practice:
- The practice offered language classes to newly registered eastern European patients. During new patient health checks for this population, additional time was also allocated to enable the clinician to explain the NHS health care system and manage patient expectations.
The areas where the provider should make improvements are:
- Continue to review and act upon the results of patient satisfaction surveys in order to meet the needs of their patient population in the future.
- Continue to review access to the service and assure themselves that they are able to provide an appropriate number of appointments to meet patients’ needs.
- Continue to improve the identification of carers to enable this group of patients to access the care and support they require.
- The provider should continue to review and document the immunisation status of the staff team.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice