Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr AMJ Bower and Partners known as ‘Bow Medical Practice’ on 3 November 2015. Overall Bow Medical Practice is rated as outstanding.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. The practice had a low threshold for reporting so that all opportunities for learning from internal and external incidents were maximised.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. The non clinical business partner chaired the pan Devon and Mid Devon practice manager’s forums and was a practice manager representative on the local medical committee.
• Feedback from patients about their care was consistently and strongly positive.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet people’s needs. The hospital based diabetic service was being extended to provide appointments at a local community hospital following feedback from the practice.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group.
• The practice had good accessible facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand

We saw several areas of outstanding practice including:

• The practice has a strong vision, which puts quality, effective care and treatment as its top priority. The partnership is structured with distinct roles and responsibilities, utilising the experience and skills of partners to the full. As a result, all business and clinical matters are delivered effectively at the practice.
• The practice provides truly holistic patient centred care. Many examples were seen demonstrating that patients were treated with dignity and received compassionate care. Carers and patients verified that GPs went above and beyond what was expected of them, for example providing 24 hour/7 day telephone access and support for vulnerable patients receiving end of life care.

• The management of the quality and health outcomes for patients at the practice is based on a comprehensive and responsive approach to local need. A proactive approach towards self-management and health is delivered in partnership with the Patient Participation Group. For example, patient support groups have been set up for patients. These include a walk and talk group to improve fitness and reduce the risk of social isolation.
• The leadership at the practice inspired a shared purpose, which was aimed at providing patient services closer to home. A GP held qualifications enabling them to provide acupuncture to patients for pain relief. Another GP was supervising a community healthcare worker with a post graduate qualification so that they would be able to provide additional treatments, such as steroid injections, which would normally be carried out at the hospital.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice