Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Beacon Medical Centre on 11 April 2017. Overall the practice is rated as good with requires improvement in the well led domain..

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

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment. Staff were encouraged and actively supported to develop their roles.
• There were GPs with a special interest (GPwSI) in dermatology and orthopaedics which meant patients could receive specialist treatment at the practice.
• The practice employed a pharmacist one day a week who performed roles to assist the GPs at the practice. These roles included patient medicine reviews and audit.
• Results from the in house patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was not readily available in written format and difficult to access online. However, improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• Patients said they appreciated the minor injury service provided by the practice.
• The main practice had good facilities and was well equipped to treat patients and meet their needs. This included a designated operating theatre where carpel tunnel surgery and skin cancer surgery was performed. The GPs were in discussions with NHS estates regarding the development and upgrade of the branch site as they recognised improvements were required.
• There were age appropriate toys and books in the waiting room and an interactive flooring area that was popular with children.
• Recruitment was well managed and detailed systems were efficiently used to monitor staff recruitment and employment issues.
• The prescriptions team at the practice worked closely with the local pharmacies to ensure blister packs were provided for older people with memory problems.
• One of the GPs was a dementia champion and used their knowledge and experience to make early diagnosis and referrals as necessary.
• One of the GPs sits as a trustee on a voluntary basis at the local Memory Café and personally led the work to secure an Admiral Nurse for the town, now in place. (Admiral Nurses are specialist dementia nurses who give expert practical, clinical and emotional support to families living with dementia). Staff at the practice supported fundraising for this service.
• 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 the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.
• The practice were proactive in the care of patients with dementia. One of the GPs was a dementia champion and had used their knowledge and experience to make early diagnosis and referrals as necessary. 79.1% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which was better than the national average (30-75%). Another GP had acted as a trustee on a voluntary basis at the local Memory Café and supported fundraising to secure an Admiral Nurse for the town, now in place.

The areas where the provider should make improvement are:

• Review systems and records so they reflect the discussions and actions taken to ensure staff who do not attend the significant event meetings are fully aware of learning and outcomes.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice