Archived: Apple Tree Medical Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Apple Tree Medical Practice on 2 December 2015. 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 the reporting and recording of significant events. People affected received support and an apology where this was appropriate.

• Feedback from patients about their care was consistently positive. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• Risks to patients were assessed and well managed with involvement from the wider multi-disciplinary team and external agencies.
• Clinical outcomes were good and the practice had achieved 99.8% of the total for the Quality and Outcome Framework (QOF) in 2014.15, with an overall exception reporting rate of 8.8% (consistent with national and local average percentages).
• Urgent appointments were available on the day they were requested. Access to routine appointments could be difficult with waiting times between three to six weeks observed on the day of our visit. The practice were undertaking a review of their appointment system to increase the availability of non-urgent appointments.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. This was kept under review by the practice which used audit as a mechanism of ensuring that patients received safe and effective care.
• Staff had the skills, knowledge and experience to deliver effective care and treatment. Staff undertook training appropriate to their roles, and had received an annual appraisal with any further training needs identified and supported by the practice.

• Information about services and how to complain was available and easy to understand.
• There was a clear leadership structure and staff felt supported by management.
• 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. For example, a self check-in system had been installed in response to comments about lengthy waits at reception.
• The practice had a dedicated carers’ champion to help support the identified carers of patients registered with the practice.
• The practice worked with other local practices and engaged with their Clinical Commissioning Group (CCG) to improve services.
• Disabled access was restricted in terms of access to the main entrance and the main reception desk. The practice were in the process of reviewing this issue.

The areas where the provider should make improvement are:

• Improve the availability of non-urgent appointments for patients.

• Review disability access to the site in accordance with the requirements of the Equality Act

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice