Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Carmel Medical Practice on 18 March 2015. Overall the practice is rated as good. Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well-led 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. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• 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 could get an appointment, with urgent appointments available the same day. Data and some feedback from patients showed it was not always possible to make an appointment with a named GP and to easily get through on the telephone. The practice demonstrated they were taking steps to try and address these issues.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Staff felt supported by all staff at the practice. The practice proactively sought feedback from staff and patients, which it acted on.

We saw areas of outstanding practice. Some examples are detailed below:

• The practice was using innovative and proactive methods to improve patient outcomes and it linked with other local providers to share best practice. New evidence based techniques were used to support the delivery of high-quality care and high performance was recognised by credible external bodies. Two GPs at the practice were GPs with special interests (GPSI); one in cardiology and the other in respiratory medicine. The practice was able to manage more complex patients within the practice. The GPSIs encouraged peer to peer referrals within the CCG area; both of which we were told helped reduce referrals to secondary care consultants.
• A comprehensive electronic system was in place for replacing emergency medicines that were used. The system operated on a ‘real time’ basis which mitigated the risk of medicines not being available or expired.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people, including attendance at multi-disciplinary meetings from the voluntary sector, for example Age Concern. Records showed these patients had been visited by the voluntary sector as part of their package of multi-disciplinary care.
• The practice actively promoted diabetic patient education schemes and a locally procured CCG scheme and could demonstrate a high uptake from patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice