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Cricket Green Medical Practice Good

Reports


Inspection carried out on 18 December 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cricket Green Medical Practice on 18 December 2015.

Overall the practice is rated as 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. All opportunities for learning from internal and external incidents were maximised. 

  • Feedback from patients about their care was consistently and strongly positive.

  • The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet people’s needs. The local multi-disciplinary team attended the practice’s monthly educational meetings in order that patients needs could be discussed. They had a strong relationship with their Patient Participation Group (PPG) and sought their views on all aspects of the running of the practice that impacted patients.

  • The practice implemented suggestions for improvements and made changes to the way it delivered services in response to feedback from patients and from the patient participation group.

  • All staff had been trained as “health champions”, which provided them with insight into difficulties encountered by patients, and enabled them to confidently participate in health promotion initiatives. Positive feedback was received from patients about the improvement to the service they received from reception staff following this training.

  • The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand.

  • The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and staff had the opportunity to contribute during an away-day.

  • The practice had received the gold standard Investors in People award in December 2013, which recognised the success of its leadership approach.

We saw several areas of outstanding practice including:

  • In response to feedback about the availability of appointments, the practice had introduced a new system whereby all consultations with adult patients were initially conducted by phone with a GP. During the consultation the GP would either resolve the patient’s issue or arrange for them to be seen in person with an appropriate member of staff. The practice had analysed the impact of the new system and had found that it resulted in a significant increase in appointment availability. Patient feedback about the system was also very positive.

  • All staff, including non-clinical staff, had been trained in health promotion, which enabled them to become involved in initiatives such as promoting COPD screening for smokers. This training also increased the awareness amongst non-clinical staff of difficulties encountered by certain patient groups, and we were told by the Patient Participation Group that they, and the patients they had spoken to about the service, had noticed an improvement in the way that staff interacted with patients since having this training.

  • The practice had introduced a comprehensive appraisal system for all staff (including GPs), which included a 360º feedback exercise.

However, there was one area of practice where the provider should make improvements:

  • The practice should consider having all portable appliances tested by a qualified electrician, and should it decide that this is unnecessary, ensure that it has a comprehensive risk assessment and mitigation plan for this decision.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Inspection carried out on 20 May 2014

During a routine inspection

Cricket Green Medical Practice is a large GP practice based in Mitcham, providing primary care services to around 10 000 patients. During our inspection we inspected regulated activities of diagnostic, screening treatment of diseases and injury.

Cricket Green Medical Practice is a modern, purpose built surgery, established at its new site since 2009. In addition to standard primary care services the practice offers many specialised clinical services, such as maternity care and anti-coagulant clinics. The practice offers extended opening hours including Saturday morning appointments.

We spoke with eight patients and received 20 comments cards. All the patients we spoke with and comment cards received rated the care given as being good. However patients reported being unhappy with the current appointments system which they described as inflexible and difficult to make appointments. The practice told us they were aware of the feedback from patients and they were introducing a new appointments booking system from 9 June 2014.

The practice had systems to report, record and review incidents. Patients were protected from the risk of abuse because staff had received appropriate training and they were aware of how they would raise safeguarding concerns. There were appropriate systems in place to manage medicines, and patients were protected from the risk of infection. We found that good systems were also in place to deal with emergencies and emergency equipment was available and regularly checked.

The practice promoted best practice by implementing care based on published guidance. Local CCG meetings were attended by GPs, where among other subjects; current developments in care were discussed. Good systems were place for monitoring and improving outcomes for patients by ensuring that health reviews occurred at specific times and referrals were followed up to ensure patients received timely care. We found that clinical audits were used as a quality improvement tool for the care provided to patients. Health promotion leaflets were accessible for patients to enable them to make informed choices.

The practice was caring, comments cards received and patients spoken with all demonstrated that patients were treated with dignity and shown empathy. Support was offered to bereaved families and a local carer’s support group was available. The practice operated a Patient Participation Group (PPG) whom they worked closely with to improve patient care. Patients told us that they felt involved in decisions related to their care and treatment and their decisions were respected. We observed that staff maintained patient confidentiality at all times.

Patients varying needs were responded to, this is because care and services provided were tailored to the needs of the local population. Extended hours and Saturday morning clinics were offered at the practice which allowed flexibility to patients. Patients were offered online appointment bookings and repeat prescription requests which allowed flexibility to all patients. The practice welcomed feedback and participation from patients and the PPG and had responded to concerns about the appointments system.

The practice had a clear, written vision and strategy to deliver high quality care and promote good outcomes for patients. The strategic plan was clear and incorporated in the appraisal system for staff. Audit systems were used to ensure adequate monitoring of patient care with the aim of improving care and delivery. Staff were provided with learning opportunities to develop their skills and maintain good clinical practice.

Older people had access to a group of GPs and they received regular health reviews. Emergency appointments were available for mothers, babies and children.

The practice was able to register patients who lived in the area temporarily and they had a policy for following up mental health patients who failed to attend appointments.