Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Carn to Coast Health Centres on 8 March 2016. 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 an effective system in place for reporting and recording significant events.

• Risks to patients were assessed and well managed.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.

• All 58 patients expressed high levels of satisfaction about all aspects of their care and treatment at the practice during the inspection. They said they were always 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 staff responded immediately to their request and found it easy to make an appointment with a named GP for continuity of care, with urgent appointments available the same day.

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

  We saw areas of outstanding practice:

• Carn to Coast Health Centres was proactive in understanding the different needs of groups of people. We saw several examples including the trusting rapport that GPs had developed with a gypsy and traveller community. Data showed that the practice was effective in improving health outcomes for 134 people living there with increased engagement with health monitoring, national screening and immunisation programmes.

• The involvement of other organisations and the community was integral to how services were planned. For example, the views of approximately 1,000 vulnerable older patients in the nearby community of St Day had been listened to regarding future access to GP and pharmacy services. The branch surgery had been under threat due to financial viability. In response, the practice provided legal representation for the community to challenge NHS stakeholders about the future services there. As a result, the branch surgery was able to stay open.

• A home detoxification service for patients recovering from addictions under close supervision of GPs with expertise in this area, supported by secondary service specialists at the mental health partnership Trust. Participation in an bringing specialist diabetes care closer to home, which had so far had enabled

The areas where the provider should make improvement are:

• Review the storage and use of injectable glucagon by referring to the purchase invoice and demonstrating that 18 months has not elapsed from delivery for safe patient use.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice