Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Mahendra Patel, Shay Lane Medical Centre, on 7th June 2016. Overall the practice is rated as outstanding.

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

• People were protected by a strong, comprehensive safety system and a focus on openness, transparency and learning when things went wrong. Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.

• Outcomes for patients were consistently better than expected when compared with other similar services. The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. They had a responsive and flexible appointment system adapted on a daily basis to meet patient demand.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Feedback from patients about their care was consistently positive.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they met patients’ needs. They had created a carer’s champion role and identified and made contact with all carers. The number of carers identified and supported since March 2016 had more than doubled to 76 which was 1.32% of the practice population...

• Services were tailored to meet the needs of individual people and ensured flexibility, choice and continuity of care. 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. They had targeted “did not attend” (DNA) rates (failed appointments) and created leaflets to educate patients on the impact.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice actively reviewed complaints and how they are managed and responded to, including verbal complaints, and made improvements as a result.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.
• We received 82 comments cards and all were positive
• The practice scored consistently high and achieved 100% for all Quality Outcome Framework (QoF) over the past three years with very low (always under 2% overall) exception reporting rates.

We saw areas of outstanding practice including:

• There were consistently high levels of staff and patient satisfaction and patient satisfaction results were consistently higher than national and local averages.

• There was a strong collaboration and support across all staff and a common focus on improving quality and people’s experiences.For example, the practice contacted the Action for Hearing Loss Charity and a member of clinical and administration staff attended training in basic sign language. The training enabled them to promote good practice and excellent communication for patients who were hard of hearing.The training was communicated throughout the practice and raised staff awareness of their duties under the Equality Act 2010 and Disability Equality Duty and provided positive interventions for patients with disabilities.

• The practice had recently commissioned practice leaflets in braille for the blind and partially sighted because they had some partially sighted patients and knew this would create a positive impact on their experiences at the practice.

• The lead GP of the practice conducted negotiations to secure and enable the relocation of pharmacy services into an on-site facility. This was done as a direct result of feedback from patients. The lead GP also undertook the discussion, co-ordination and planning of the alterations of the premises to facilitate the relocation which also resulted in additional car parking. Patients reported that the pharmacy had been very positive for both practices at the Medical Centre, reducing the amount of time spent from consultation to receipt of medicines and also giving patients the opportunity to pick up other essentials they might need without having to travel to another location when they were feeling unwell.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice