Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bramingham Park Medical Centre on 25 October 2017. The overall rating for the practice was good with requires improvement for providing responsive services. The full comprehensive report on the October 2017 inspection can be found by selecting the ‘all reports’ link for Bramingham Park Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 10 August 2018 to confirm that the practice had made the recommended improvements that we identified in our previous inspection on 25 October 2017. This report covers our findings in relation to those improvements made since our last inspection.

Overall the practice is rated as good.

Our key findings were as follows:

• An action plan had been put in place to make improvements to the practice which included access and appointments, the telephone system and customer service.
• The practice and the patient participation group had completed their own surveys and questionnaires to identify areas for improvements.
• The NHS Friends and Family Test (FFT) was actively used to monitor patient satisfaction.

Additionally, where we previously told the practice they should make improvements our key findings were as follows:

• The practice had reviewed their list of carers and found that some were incorrectly identified. They now had 30 patients identified as carers which was less than 1% of the practice list size. These patients had an alert on their electronic computer record and they were informed of a bypass telephone number so they could contact the practice without waiting in a queue for the for their call to be answered. The practice had an identified carers champion, a carers noticeboard in the waiting area and written information was available to direct carers to the various avenues of support available to them. There was a carers café held every other month. All carers were offered an annual health check and flu vaccination.

There were areas of practice where the provider should make improvements:

• Continue to review patient satisfaction in response to changes made in the practice following the national GP patient survey.
• Continue to identify patients with caring responsibilities.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bramingham Park Medical Centre on 25 October 2017. 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 a system in place for reporting and recording significant events.
• The provider had a central governance team who supported the practice to investigate and manage significant events, incidents and complaints.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Practice specific policies were supported by overarching provider policies.
• 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. The practice was supported by the providers learning academy to develop their staff.
• Results from the national GP patient survey, published July 2017, showed patients rated the practice below average for some aspects of care provided by GPs but they were in line with local and national averages for the care provided by the nursing staff.
• The provider was aware of areas where patient satisfaction had not been achieved and had formed an action plan and implemented measures to make improvements.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• The practice had good facilities and was well equipped to treat patients and meet their needs. There were accessible facilities, which included a hearing loop, access enabled toilets and electronic entrance doors. All consultation and treatment rooms were on the ground floor.
• 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 areas where the provider should make improvement are:

• Implement and review outcomes of the practice improvement plans to increase patient satisfaction with the service.
• Monitor patient feedback through the national GP patient survey, NHS Friends and Family test and practice surveys to continue to identify and ensure improvement to patient experience.
• Continue to identify and support carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bramingham Park Medical Centre on 26 January 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, well-led, caring and responsive services. It was also good for providing services for all of the population groups. It required improvement for providing effective services.

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.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• 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 but the practice needed to assure themselves that patients could contact them if they were not satisfied with the outcome of complaints.
• Patients said they found it easy to make an appointment although continuity of care was an issue which was being addressed.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• 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.

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

Importantly the provider should:

• Ensure that significant event documentation include clear details regarding who was responsible for carrying out any actions, what had been done to prevent the incident reoccurring and ensure a robust system that informs all staff of the outcomes .

• Introduce a robust process is in place for dissemination to all clinical staff of new NICE guidelines or changes in local guidance.

• Develop a programme of clinical audit and ensure engagement from the GPs as well as nursing staff.

• Introduce a more collaborative and robust strategy to manage some of the QOF clinical areas to include more involvement of the GPs.

• Amend the current process for dealing with complaints to assure themselves that patients have had an opportunity to discuss the outcome with the practice if they are not satisfied. They should also ensure that all actions are recorded and detailed outcomes are shared with the relevant staff to ensure that lessons have been learnt.

• Ensure all relevant staff are appropriately trained and supported in the process for dealing with test results and electronic discharge letters to eliminate the potential for error.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice