Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Belvedere Medical Centre on 17 September 2015. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• 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 found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Most risks to patients were assessed and well managed, apart from those relating to medical emergencies and Legionella.

We saw some areas of outstanding practice:

• The practice had developed an innovative staffing model for providing patient care. The practice had a very good skill mix, which included advanced nurse practitioners (ANPs), a ‘non-medical prescriber’ practice nurse, a pharmacist and a primary care assistant practitioner (PCAP). They were all able to see a broad range of patients so that the clinical workload was successfully shared across the team. The feedback from patients indicated a high level of satisfaction with this model of care; patients had good access to the practitioner of their choice.

• There was a clear leadership structure and staff felt supported by management. Staff were empowered to make suggestions and implement changes to improve the quality of the service. For example, one of the practice nurses had identified chlamydia testing as an area for improvement and taken successful actions leading to improved detection rates. This had led to an improved rate of chlamydia testing and one of the highest levels of chlamydia detection rates for the practice population as evidenced by recent figures provided by clinical commissioning group (CCG).

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Ensure that actions resulting from the Legionella risk assessment are implemented, so risks are managed appropriately.

• Continue to review arrangements for responding to medical emergencies to ensure that the equipment is immediately available for use, staff are aware of its location and are trained to use it.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice