Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Coastal Medical Group on 04/11/2015. 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 reporting and recording significant events. 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.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they sometimes found it difficult to make an appointment in advance with a named GP but there was continuity of care, with urgent and some non-urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice was currently taking part in an initiative offering patient’s access to a GP from 8am untll 8pm as part of a Prime Ministers Funding Initiative.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw some areas of outstanding practice:

• The use of ‘Florence’ a simple tele-health service to advise and assist patients to manage their own conditions with arm’s length support from professional should a change in their condition be detected.
• The practice had self-funded the employment of two advance nurse practitioners and one trainee advanced nurse practitioner as part of a continuity of care programme. This had allowed patients to have greater access to support in the practice, and had meant that GP’s had more free slots to see patients who required their specific assistance with their needs.
• The practice had received national recognition for their work with the Gold Standard Framework (care for patients at the end of their lives) and Palliative Care.
• The practice had a cohesive and effective medicines management team who worked alongside the GP’s for maximum optimisation of patient’s medication and they had managed to save £240,000 in last year through more effective medicine management.
• The practice had successfully gained approval to offer third year student nurse placements at the practice and were now supporting other practices to achieve this status.
• The medicine management team monitored patients who were prescribed an increasing dose of medication and contacted them to ensure they were managing their increases in a timely manner.

One area where the provider should make improvement is:

• Developing an annual audit plan for the practice, this will allow the practice to plan their activity demonstrating a review of care and processes from a strategic level rather than adhoc audits.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We spoke individually with the registered manager, senior managers and staff at Coastal Medical Group. We also discussed care with three patients and two relatives. We reviewed staff records, policies and procedures and various audit records.

The service ensured that whilst people were receiving treatment, they were cared for in a supportive and respectful manner. One person told us, "I’m very happy with my practice". Additionally, people expressed feeling in control of their treatment and felt decisions were made jointly.

The service had effective safeguarding practices in place. Staff had a good understanding of related principals. Training and supervision were provided and staff we spoke with told us they felt highly supported.

Coastal Medical Group had a variety of appropriate processes in place to monitor the quality of service provision. The practice had effective systems to manage complaints appropriately.

We reviewed the information available to us about Bay Medical Group on 2 May 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.