Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Budbrooke Medical Centre on 25 April 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 which all staff were aware of.

• The practice had clearly defined and embedded systems to minimise risks to patient safety. Staff were aware of current evidence based guidance and took measures to ensure that changes in guidance were discussed and shared with staff. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• 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 achieved consistently high levels of satisfaction from the national GP patient survey and their own survey and showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment. Patients we spoke with and CQC comments cards were also unanimously positive and patients expressed how the actions and additional support of the GPs and other staff had had a positive impact on how they dealt with, and adjusted to life when coping with particularly difficult diagnoses and specific long term conditions. Patients told us how the GPs provided their own telephone number to patients during the end of life and provided additional home visits to support them. All staff we spoke with demonstrated that the caring practice ethos was embedded in their work.
• 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 as well as telephone consultations. One hundred percent of patients said they could get through easily to the practice by phone compared to the national average of 73%.
• 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 had made significant changes in the last two years and strengthened and developed their management team which had improved efficiency in the practice.
• The practice had an active patient participation group as well as a virtual group who worked well with the practice and provided feedback, which was well received and acted upon.
• 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.

We saw areas of outstanding practice:

• The practice had a lead GP for mental health and dementia who had undertaken additional training in these areas. Their proactive approach to dementia had led them to explore their patient population and review patients who may have been at high risk of dementia. This had increased the number of patients identified as living with dementia. The practice had engaged in a local pilot project to identify and investigate patients with the potential for a diagnosis of non-complex dementia. The GPs gave several examples of how in depth consultations had resulted in significant benefits to both patients and their carers.

• The practice had engaged in two leadership programmes where key staff had developed their skills in change management, succession planning and leadership. They had introduced new systems and ways of working which enabled the practice to function more efficiently allowing more time for patients and clinical reflection. They had involved all levels of staff seeking ideas and views to ensure effectiveness, engagement and ownership.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice