Letter from the Chief Inspector of General Practice

We carried out a planned comprehensive inspection of Chainbridge Medical Partnership on 20 January 2015.

Overall, we rated the practice as good. We found the practice to be good for providing safe, effective, caring, responsive and well-led services. Our key findings were as follows:

• The services had been designed to meet the needs of the local population.

• Feedback from patients was positive; they told us staff treated them with respect and kindness.

• The practice was visibly clean and tidy.

• The practice learned from incidents and took action to prevent any recurrence.

• There was a clear leadership structure and staff felt supported by management. The practice actively sought feedback from patients

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Chainbridge Medical Partnership on 15 January 2019 as part of our inspection programme.

At the last inspection in January 2015 we rated the practice as good overall and as good for delivering safe, effective, caring, responsive and well-led services. However, it was rated as outstanding for the population group relating to people experiencing poor mental health because:

• The practice Quality Outcomes Framework (QOF) attainment in relation to ensuring patients with a mental health condition were higher than local and national averages.
• They had a higher than average attainment in ensuring patients with a mental health condition had a comprehensive care plan.

We have based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and good for all population groups with the exception of the population group relating to people with long term conditions which has been rated as outstanding.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

We saw several areas of outstanding practice including:

• The practice cared for and monitored 91% of their diabetic patients in-house without the need for secondary care intervention which included an insulin initiation service. As they had felt that QOF attainment in relation to diabetes could improve the practice had introduced a monthly audit system to ensure diabetic patients were receiving appropriate and regular monitoring. The practice also held a monthly diabetes meeting and six weekly meetings with diabetic consultants and specialist nurses.
• They had an effective system in place to monitor patients prescribed high-risk medicines. They had a programme of weekly, monthly and quarterly medicine searches to ensure patients were receiving appropriate monitoring.
• The practice had a comprehensive and effective programme of meaningful clinical audit activity which could demonstrate improvements to patient care and outcomes. This was of particular benefit to patients with long term conditions on regular medication.
• They had developed a ‘patient notes safety system’ which helped to ensure that vulnerable patients were not missing monitoring, health or medication reviews or missing appointments. This was checked daily by either the practice manager or assistant practice manager.
• The practice regularly employed apprentices as part of their non-clinical staffing team and supported them with training and in obtaining National Vocational Skills Qualifications. Several of their apprentices had either became permanent members of staff or progressed to posts or advanced qualifications in the health care sector. The practice had been recognised by the National Skills Academy for their work in supporting apprentices

Whilst we found no breaches of regulations, the provider should:

• Establish a patient’s participation group and seek members views in relation to the future running and development of the practice.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice