4 October 2019
The registered provider of the practice is Concierge Medical Practice, an independent service founded in 2013 to provide healthcare to individual clients (adults and children) in the Cotswolds. The service is based in Lynley House, Moreton Paddox in Warwickshire and provides healthcare to approximately 1200 patients throughout the Cotswolds.
The practice is registered with the CQC to carry out the treatment of disease, disorder or injury regulated activity.
Concierge Medical Practice is a limited company with a board of directors, two teams of doctors, an operations team which includes the practice manager and an operations manager. They operate as a membership practice that provides consultations only at a patient’s home or office only. Advice is available through a dedicated members telephone line with consultations generally available from 8am to 8pm Monday to Friday. Urgent or pre-arranged consultations are available within these hours during weekends or bank holidays. A duty doctor is available at all times, including weekends and bank holidays to respond to any urgent calls. No locum or agency doctors are used.
How we inspected this service
Before our inspection we reviewed information we held about the practice. We also reviewed information that we had received from the provider ahead of the inspection and information available on the providers’ website. We also reviewed patient feedback submitted directly to CQC.
The methods that were used included feedback comments from people using the service, interviewing doctors, the practice manager and review of documents.
To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:
- Is it safe?
- Is it effective?
- Is it caring?
- Is it responsive to people’s needs?
- Is it well-led?
4 October 2019
This service is rated as Good overall with rated outstanding for providing responsive services.
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? – Good
We carried out an announced comprehensive inspection at Concierge Medical Practice on 21 May 2019 as part of our current inspection programme. The practice had been inspected on 11 January 2018 under our previous methodology and no rating had been applied.
This service is registered with CQC under the Health and Social Care Act 2008 to provide independent GP services to individual patients in their locality. Thirteen patients provided feedback directly to the Care Quality Commission (CQC). All comments were extremely positive about the service experienced. Patients commented that doctors were friendly, professional and polite, and that nothing was too much trouble. They felt they were well treated and cared for and that doctors responded to their concerns quickly which gave them the reassurance they needed.
Our key findings were:
We found that:
- The practice provided care in a way that kept patients safe and protected them from avoidable harm.
- There was an open and transparent approach to safety and a system in place for recording, reporting and learning from significant events. The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents happened, the practice learned from them and reviewed their processes to ensure improvements were made.
- There were clearly defined and embedded systems, processes and practices in place to keep people safe and safeguarded from abuse and for identifying and mitigating risks of health and safety.
- Patients received effective care and treatment that met their needs.
- The practice organised and delivered services to meet patients’ needs. Patients said that they could access care and treatment in a timely way.
- The practice reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines and best practice.
- Patients told us that all staff treated them with kindness and respect and that they felt involved in discussions about their treatment options.
- Doctors had the appropriate skills, knowledge and experience to deliver effective care and treatment.
- Policies and procedures had been kept under regular review and updated accordingly. There were clear responsibilities, roles and systems of accountability to support effective governance.
- The way the practice was led and managed promoted the delivery of high-quality, person-centred care.
- There was a strong focus on continuous learning and improvement at all levels of the organisation. There was a practice development plan that documented both long and short-term priorities for the service.
- There was visible practice and managerial leadership with audit arrangements in place to monitor quality.
We saw areas of outstanding practice:
- There were no set limits to consultations so doctors were are able to make a full assessment of medical needs, particularly for those patients with complex, long-term conditions, co-morbidities and/or general age-related frailty.
- All patients have a named doctor to oversee their care with buddy arrangements in place to cover absences.
- We saw examples where doctors had exceeded expectations in treating patients with care and compassion which included for example, treating visiting relatives of patient members (who were non-members) and calling in to see patients if they suspected something was not as it should be with them.
- In addition to home visits, patients had been visited at work, accompanied to hospital (to support both the patients and their families and act as their advocate), supported them in respite and nursing homes and at schools.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care