Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Caen Medical Centre on 3 February 2016. Overall the practice is rated as outstanding.

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

• 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.

• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, a GP partner was the MacMillan GP facilitator for the area and regional advisor. They shared their knowledge and expertise in this area, providing leadership and facilitation of improvements for patients experiencing the palliative care pathway across the region.

• Feedback from patients who used the service, family members and carers, and stakeholders was continuously positive about the way staff treated them and other patients. Patients said staff went the extra mile and the care they received exceeded their expectations. Feedback from all 48 patients about their care was consistently and strongly positive.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs.It enabled these services to provide clinics for patients at the practice making these more accessible for patients and their carers. For example, strength and balance classes were held for people at risk of falling.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group. For example, the appointment system had been completely overhauled and patients reported improved access and support.
• A walk in phlebotomy clinic was held every day between 8:30am to 10:30am, and between 2pm and 3pm on Tuesday, Wednesday and Thursday. The latter clinic aimed to provide a later service for patients with chronic health conditions who may find it difficult to attend earlier in the day.
• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.

We saw several areas of outstanding practice including:

• Caen Medical Centre has embraced the concept of living well and was facilitating the integration of services to specifically bring care and treatment closer to home for patients. Examples included; developing a community hub bringing services closer to home for patients. The promotion of healthier living which was aimed at reducing the risk of unplanned hospital admissions where ever possible and improved quality of life.For example, older patients at risk of falling were able to attend strength and balance classes every week to improve their stamina and reduce the risk of injury from falls.Holding key roles in some of the 19 local charities identified as being able to support patients who could be at risk of social isolation.Developing a local walking group and driving forward the concept of a ‘compassionate community’ within Braunton.Patients were signposted and able to access services from within the practice with the aim of avoiding unplanned hospital admissions.

• The practice engaged with young people in using and developing the services at Caen medical Centre ahead of NHS England publishing the initiative entitled “You’re welcome” encouraging services to explore young people’s needs. The practice undertook a survey with young people in the town and gained some insight into their needs. This work had raised awareness across the team of the young people’s attitudes. As a result of this work, the school nurse, in conjunction with the practices GPs, began running a clinic at the local secondary school once weekly.

• The practice held a carers focus group in June 2015, in which 20 carers had been invited and eight attended. Carer’s suggestions to increase information on the practice website and in the waiting rooms regarding support available. We saw the practice website and information in the waiting room raised awareness about support services such as Devon Carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice