Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cross Street Health Centre on 25 May 2016. Overall the practice is rated as good.

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

• We observed a strong patient-centred culture and we saw that staff treated patients with kindness and respect, and maintained confidentiality. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• The practice offered a range of clinical services which included care for long term conditions and services were planned and delivered to take into account the needs of different patient groups to ensure flexibility, choice and continuity of care.

• The practice was proactive in identifying and managing significant events. Opportunities for learning from internal and external incidents were maximised.

• Performance data across some areas was below average, including uptake for cervical screening and for identifying and supporting patients who would benefit from smoking cessation advice.

• The practice had identified the need to take a more proactive approach in managing medication reviews. During our inspection we saw data to demonstrate that some improvements had been made in this area and that an ongoing piece of work was in place to ensure that regular reviews were taking place as appropriate.

• All patients who were registered with the practice had a named GP and patients could access appointments and services in a way and at a time that suited them.

• Staff spoken with demonstrated a commitment to providing a high quality service and throughout our inspection we noticed a theme of positive feedback from staff.

• There was a systematic approach to working with other organisations to improve patient care and outcomes. The practice had clearly defined and embedded systems, processes and practices in place to keep people safe and safeguarded from abuse.

• A programme of continuous clinical and internal audit was used to monitor quality and to make improvements.

• 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.

We saw an area of outstanding practice:

• Approximately 39% of the practice population were non-English speaking patients. We saw how the practice had started to utilise a local Integrated Plus scheme to specifically support their non-English speaking patients. As a result, these patients were supported in a variety of ways such as signposting them to befriending services used by others who did not have English as a first language. These patients were helped to use public transport in order to attend appointments in secondary care.

The areas where the provider should make improvements are:

• Continue to identify carers and ensure that all carers are captured on the computer system, in order to provide further support where needed.

• Continue to explore ways to engage with patients who do not attend for cervical screening, in order to ensure screening is taking place as appropriate and improve uptake.

• Continue to engage with patients and work on improving overall medication reviews and ensure that regular reviews are taking place as appropriate.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

On the day of our inspection we spoke with seven patients and five members of staff. One patient said, “They are very good, smashing doctor." The patients we spoke with said they were unable to obtain appointments at a time to suit their needs and that they had to wait a long time once they arrived at the practice. However, all the patients we spoke with said they felt the quality of care they received was good and they never felt rushed.

We saw that patient's views and experiences were taken into account in the way the service was provided and that they were treated with dignity and respect. One patient told us, “The doctors are very helpful and supportive." We saw that patients experienced care and treatment that met their needs. Patients told us and we saw that care was delivered in a clean environment.

Staff were knowledgeable about safeguarding and were aware of whom to report concerns to.

There were good systems in place to assess and monitor the quality of service that patients received.