Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Danetre Medical Practice on 2 December 2015. Overall the practice is rated as good.

Our key findings across all 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 had been maximised.

• Risks to patients had been identified and assessed and well managed to minimise those risks.

• The practice was actively involved with local and national initiatives to enhance the care and treatments offered to patients. Practice staff were proactive in piloting new ways of working to improve meeting the needs of patients.

• Patients we spoke with said they were treated with respect and they felt involved with decisions about their care and treatment. They commented about how helpful staff were towards them. Information was available and details of support groups to help them understand about their care needs.

• Practice staff listened and when possible implemented suggestions for improvements and made changes to the way they delivered services. Information about how to make a complaint was available and easy to understand.

• There was a structured programme in place for staff annual appraisals and for planning their training needs. Staff were actively encouraged to enhance their knowledge and skills.

• There was a clear leadership structure and staff told us they felt supported by senior staff and that there was an open culture throughout. There was a clear vision to promote high standards of care. There was a comprehensive governance system in place to monitor the quality of practice wide performance.

We saw areas of outstanding practice including:

• A new post of ‘care co-ordinator’ was established in 2015. The staff member was responsible for the interface and seamless care for patients between primary, secondary (hospital), community care and voluntary organisations. They monitored care of 3% of patients with the most complex needs. The care co-ordinator received and collated information on hospital admissions and discharges including the out of hour’s service. They presented information to the lead GP, multidisciplinary teams and all other services involved, such as; social services. They arranged for tests and referrals to be carried out and made courtesy calls to patients who were on the community matron’s case list and following discharge from hospital. The system provided a comprehensive audit trail of the care provided; identified where more care was required and liaised with the appropriate care provider. It contributed positively to the Northamptonshire ‘frail and elderly’ community programme and served to prevent unnecessary hospital admissions.

• Clinicians carried out regional and national clinical research programmes. The GP researcher was supported by a research nurse in carrying out a wide range of programmes. For example, cardiovascular risk management of patients who experienced mental health illness, bowel/lung cancer and antibiotic prescribing for children who were experiencing flu type symptoms. The results of the research were shared widely and influenced appropriate patient care.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice