Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cambridge Access Centre on 22 August 2017. Overall the practice is rated as outstanding.

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

• The practice demonstrated there was strong clinical leadership and cohesive team working with both the practice team and with other services such as drug and alcohol services to deliver health care to their specific population.

• 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. The practice had a risk calendar to monitor when risk assessments were due.

• Staff were aware of current evidence based guidance. Staff had been specifically trained to undertake the role of treating homeless patients.

• Results from the practice patient survey showed patients reported they were treated with care and would recommend the practice.

• There was evidence of the practice providing additional services to patients including receiving mail for those with no fixed abode, offering to charge mobile phones, providing lunch once per month and providing clothing and bedding to the local homeless shelter.

• The practice had identified 4.8% of their population as carers and were proactive in the management of carers.

• Information about services and how to complain was available and easy to understand. The practice recognised the population they served were more likely to give verbal feedback rather than written and had a system to record both. Complaints were fully investigated and patients were responded to with an apology and full explanation.

• For those patients who were not able to make appointments the practice offered a drop in clinic every morning at the practice and also twice weekly at the local shelter.

• A practice initiative to start a support group for patients with Hepatitis C was being advertised and they had a ‘clean needle’ campaign in place.

• The practice held a comprehensive central register of policies and procedures which were in place to govern activity.

• 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.

• The patient participation group (PPG) had recently disbanded due to unforeseen circumstances. The practice was actively trying to recruit new members and could evidence they had involved the PPG with patient surveys.

• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw areas of outstanding practice:

There was an outstanding caring culture within the practice and we saw many examples. Staff treated all the patients as individuals and patients we spoke with confirmed this. Staff had donated items such as clothing and bedding to the local shelter and provided a lunch once a month at the practice for patients. There was always fruit and biscuits available at the practice for patients who wanted them and staff ensured patients enhanced needs were met. Staff knew their population well and would phone the outreach team to check on patients if they had not been to the practice for a period of time. When patients were admitted to hospital, the practice checked they had essential personal belongings. A common mode of transport for patients was by bicycle which had to be left at the front of the building, so the practice provided bike locks to ensure they were kept safe. Patients were allowed to charge their phones at the practice to ensure they could be contacted when necessary. For those patients with dogs, the practice provided water and shelter for them while the patient was seen by a clinician. We received 27 comment cards from patients. All 27 reported caring, professional, approachable staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice