Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Hollinwood Medical Practice on 5 March 2015. Overall the practice is rated as outstanding.
Specifically, we found the practice to be outstanding for providing caring, responsive, effective and well led services. They were outstanding for providing services to most of the population groups, specifically those who were vulnerable. We also found that safe services were good.
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. 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.
- Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided in many innovative ways to help patients understand the care available to them.
- 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 (PPG).
- The practice had good facilities and multi-skilled staff and was well equipped to treat patients and meet their needs.
- Information about how to complain was available and patients who found had difficulties understanding, were encouraged to complain verbally and supported in the process.
- The practice had a clear vision which had quality and safety as its top priority. A business plan was in place, was monitored and regularly reviewed and discussed with all staff. High standards were promoted and owned by all practice staff with evidence of team working across all roles.
We saw several areas of outstanding practice including:
- The practice had increased the flexibility and length of time of their appointments to 13 minutes instead of ten and could demonstrate the impact of this by reduced use of the accident and emergency services and positive results from clinical audits.
- The practice had a very good skill mix which included a nurse prescriber, counsellors and rehabilitation workers and was able to provide social and medical care for a focussed range of patients. They were able to demonstrate the positive impacts for this group of patients.
- The practice attended the primary schools in the area three times a year, drug and alcohol rehabilitation units and hostels to promote better health. If underlying health issues were identified patients (if they did not have a GP) were offered the opportunity to register with the practice. If they were known to the practice they were encouraged to attend for an appointment.
- The practice organised social activities such as car boot sales, open days, “come and eat cake” days and food parcels for patients in need. They were also planning parenting classes, boogie babies and a choir. They did this to build relationships with the patient population, increase awareness of what the practice offered and reduce inappropriate attendance at other services such as walk in centres or accident and emergency departments.
- Through their care and treatment of chronic obstructive pulmonary disorder (COPD) the practice had identified areas within the county where COPD was higher and people required treatment. They had shared this information with the CCG and were working to reduce the effects of this condition throughout the community.
- All staff undertook annual 360 degree feedback and appraisals that identified learning needs, from which action plans were documented. 360 Degree Feedback is a system or process in which employees receive confidential, anonymous feedback from the people who work around them. Our interviews with staff confirmed that the practice was proactive in providing training and funding for relevant courses.
- Verbal complaints were encouraged to assist people with reading or writing difficulties and staff recorded these in full.
There were some areas where improvements should be considered.
Importantly the provider should:
- Introduce a system of management responsibility for each day’s workload to ensure that nothing is missed at the end of each day.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice