Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Shinwell Medical Centre on 18 January 2017. Overall the 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. 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. For example they had set up a charitable trust to save a local community centre in response to local authority plans to close it.

• 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. Examples included; Tendering and supporting ten local Practices to develop services closer to home for patients in 2013, leading the proposed re-development of the new Peterlee Health Centre as part of the NHS Estates and Technology Transformation Fund and operating Peterlee Health Centre premises that housed six local practices since 2000, developing a Saturday opening pilot in Peterlee for 45,000 patients, and developing a new extended hours hub with seven day working in Peterlee from 1 April 2017 in collaboration with neighbouring practices.

• They had a culture of working to sustain primary care. For example they had successfully sustained a contract for a local practice that was closing in order to provide care to local patients. This had led to the practice taking on the care of an extra 800 patients.

• 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. For example the new building had been developed in consultation with patients. GPs were to be individually audited by patients in order to improve their consultation skills following recommendation by the patient participation group.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice actively reviewed complaints, including verbal complaints, and how they were managed and responded to, 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 saw several areas of outstanding practice including:

• Public health prevention and promotion as part of the NHS agenda was a priority for the practice, measures included the setting up of a local charity in order to save a local community centre (Roseby Road Wellbeing Centre) which was due for closure. This was then utilised to combat social isolation and provide health promotion for the local community. The practice also participated in the Peterlee Annual Carnival in practice staff’s own time and collaborated with the Pony Club to provide free health checks to patients. The practice also visited local primary schools to familiarise the children with medical equipment and talk about health promotion.

• The leadership in the practice drove continuous improvement and staff were accountable for delivering change. Safe innovation was celebrated. There was a clear proactive approach to seeking out and embedding new ways of providing care and treatment.

In addition the provider should:

• Increase the identification and support to carers on the practice list.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice