James Fisher Medical Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at James Fisher Medical Centre on Wednesday 25 May 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting, recording and learning from any significant events.
• Risks to patients were assessed and well managed.
• Patients said they found it easy to make an appointment with a GP, although two of the patients said this was sometimes harder to do if they wanted an appointment with a specific GP.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

• The involvement of other organisations and the local community was integral to how services were planned to make sure the practice met people’s needs. For example, the practice worked well with voluntary sector, either through a website signposting or through direct access provided within the practice voluntary suite.

• There were innovative approaches to providing integrated person-centred pathways of care that involved other service providers, particularly for people with multiple and complex needs. For example, the practice referred patients including victims of domestic violence, those with mental health problems, and women who have been trafficked to the Sunshine midwifery team for advice and support.

• There was a proactive approach to understanding the needs of different groups of people and to deliver care in a way that meets these needs. For example, the practice offered effective pre-conception advice, on site health visiting team and services of a GP who had a special interest in Paediatrics (GPwSI paeds) who could offer direct support rather than referral to the local hospital.

• The practice offered contraceptive counselling and services which included lThe GP contraception lead was a faculty registered trainer, who facilitated on-going training for GPs and nurses from other practices.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice efficiently identified patients who were carers and offered them written information and guidance and offered ongoing support.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• 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.

• The practice had provided and offered a room free of charge to voluntary services and charities. The space allowed the practice staff to work in collaboration with a number of local charities to provide services to the local community. Amongst these were the Alzheimer’s charity and CRUSE (a bereavement charity).

We saw one area of outstanding practice:

The practice was involved in a collaborative project with two other local practices in response to the needs of the over 75 year population group who were high risk of hospital admission. The project was funded by Dorset clinical commissioning group and known as the Anticipatory Care Team (ACT). The project was aimed at reducing emergency hospital admissions by offering routine care, urgent care, regular reviews and provision of proactive personalised anticipatory care plans for frail older patients who could not easily access practice facilities. We saw data that showed an 11.1% decrease in patients over 75 years attending the emergency department compared to the same period the year before. This related in real terms to 59 less patients being admitted to hospital. Data also showed an 18.2% reduction in self-referral to the emergency department. The team had also provided falls assessments, medicines reviews and, dementia assessments and screening. The team had referred patients for further care and updated care plans.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice