Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Arden Medical Centre on 29 January 2016. Overall the practice is rated as outstanding.

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

• Throughout our inspection we noticed a strong theme of positive feedback from staff, patients and other organisations who worked with the practice. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• There were consistently high levels of constructive staff engagement. The practice recognised and celebrated staff innovation and hard work. The management team worked closely together to motivate and encourage staff to succeed.

• Risks to patients were assessed and well managed. Patients’ needs were assessed and care was planned and delivered following best practice guidance. The practice had clearly defined and embedded systems, processes and practices in place to keep people safe and safeguarded from abuse.

• The practice was proactive in identifying and managing significant events. All opportunities for learning from internal and external incidents were maximised.

• The practice had an effective programme of continuous clinical and internal audits. The audits demonstrated quality improvement and improvements to patient care and treatment. Staff were actively engaged in activities to monitor and improve quality and patient outcomes

• The practice used innovative and proactive methods to improve patient outcomes and working with other local providers to share best practice. The practice was committed to working collaboratively and worked closely with other organisations in planning how services were provided to ensure that they meet patients’ needs.

• All patients who were registered with the practice had a named GP and patients could access appointments and services in a way and at a time that suited them.

• 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.

• The practice had a clear vision which had quality and safety as its top priority. We observed a strong patient-centred culture and we saw that staff treated patients with kindness and respect, and maintained confidentiality.

• The practice had a regular programme of practice meetings and there was an overarching governance framework which supported the delivery of the practice’s strategy and good quality care. Governance and performance management arrangements were proactively reviewed to reflect best practice.

• We observed the premises to be visibly clean and tidy. The practice had good facilities and was well equipped to treat patients and meet their needs. The practice took a proactive approach to the management of infection control; they operated a comprehensive programme of infection control audits, infection control spot checks and involved the CCG infection control lead in the induction programme for new staff.

We saw some areas of outstanding practice:

• The practice took a proactive approach to understanding the needs of different groups of people. This included patients experiencing poor mental health (including dementia) and in vulnerable circumstances. Opportunistic screening was undertaken for dementia during flu clinics. The practice had approached a local psychiatrist (who specialises in problems relating to learning disabilities) in order to implement a memory screening assessment form to identify problems with memory and potential dementia for their patients with a learning disability; so that further support and treatment could be arranged as appropriate.

• The involvement of other organisations and the local community was integral to how services were planned to ensure that services meet people’s needs. An in-house dermatology nurse worked with the practice to offer services such as cryotherapy twice a month. The practice was also a host site for consultant ear, nose and throat (ENT) clinics whereby an ENT consultant worked with the practice every other week. The practice was also focusing on how they could treat leg ulcers in the wider community through offering a tissue viability nursing service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice