Background to this inspection
Updated
10 August 2018
St Leonard’s practice is situated in the city centre of Exeter, Devon. The practice is located at:
St Leonard's Practice
Athelstan Road
Exeter EX1 1SB
The deprivation decile rating for this area is six (with one being the most deprived and 10 being the least deprived). The practice provides a primary medical service to approximately 9,300 patients of a diverse age group. The 2011 census data showed that the majority of the local population identified themselves as being White British.
There is a team of six GP partners and two salaried GPs providing 40 sessions per week. The GP team are supported by a practice manager (business manager), data manager, office manager, nurse practitioner, four practice nurses, three healthcare assistants (HCAs), and 14 administration staff.
Patients using the practice also have access to an independent on site pharmacy, health visitors, community nurses, mental health practitioners, osteopaths, midwives and community groups. Health care professionals visited the practice on a regular basis.
The practice is open from 8.15am to 7pm on Mondays and between 8.15 and 6pm on Tuesdays to Friday with a lunchtime closure on Wednesday between 1pm and 2pm. Appointments are offered between those times. Outside of these times patients are directed to contact the out of hour’s service and the NHS 111 number in line with local contract arrangements. Extended hours are offered on six Saturdays per year and patients also have access to out of hours services locally
The practice offers a range of appointment types including face to face same day appointments, telephone consultations and advance appointments (six weeks in advance) as well as online services such as repeat prescriptions.
St Leonard’s practice is an accredited training practice for post graduate doctors and medical students and is an established, internationally recognised research practice providing data that impacted on clinical practice and education.
This report relates to the regulatory activities provided by the practice;
Diagnostic and screening procedures
Family planning
Maternity and midwifery services
Surgical procedures
Treatment of disease, disorders or injury.
Updated
10 August 2018
This practice is rated as outstanding overall. (The previous inspection was in July 2015 – when the practice was rated outstanding)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Outstanding
Are services well-led? - Outstanding
We carried out an announced comprehensive inspection at St Leonard’s practice on 12 June 2018 as part of our inspection programme.
At this inspection we found:
- The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen there was a genuinely open culture in which all safety concerns raised by staff and people who use services were used as opportunities for learning and improvement.
- The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
- Patients said the care and treatment they received was very good and added that staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
- There was a strong focus on continuous learning and improvement at all levels of the organisation.
- The practice was organised, efficient, had effective governance processes and a culture which was embedded effectively and used to drive and improve the delivery of high-quality person-centred care.
- The involvement of other organisations, voluntary services and the local community were integral to how services were planned and ensured that services met patient’s needs.
- The leadership, governance and culture were used to drive and improve the delivery of high-quality person-centred care and were clear, supportive and encouraged creativity.
- There were high levels of staff satisfaction. Staff were proud of the organisation as a place to work and spoke highly of the culture.
- The practice was an active National Institute Healthcare Research (NIHR) centre.
We saw areas of outstanding practice:
- There was a culture of learning and education at the practice and staff had obtained further education including master degrees, doctorates and had other roles including professorships, university sub deans and clinical leadership roles. Three of the GPs had been awarded the bronze Clinical Excellence Awards, by the Advisory Committee on Clinical Excellence Awards (ACCEA). One of the GPs was recognised in particular for the educational innovations carried out at the practice that had been subsequently used in national and international contexts.
- The practice had an in house research team and undertook its own original research which influenced policy and educational curriculum changes at both local and national level. This included improving patient care and outcomes, reducing unexpected hospital admissions, improving education and improving the management of long term conditions.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice