Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Forest Practice on 11 April 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.

• The practice offered extra in-house services and home visits for people living in vulnerable circumstances. This included people requiring support with substance misuse, drug and alcohol addictions, refugees and people with learning disabilities. Patients benefited from receiving care and treatment that was closer or within their homes. This also reduced the burden on hospital services.

• Feedback from patients showed they were treated with dignity and respect, and they felt involved in decisions about their care and treatment.

• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• The practice responded to complaints that were raised and learning was shared with staff.

• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision was reviewed and discussed with staff.

• The practice had a leadership structure in place, with clear delegation of tasks and responsibilities for both clinical and non-clinical staff. Staff we spoke with felt valued and supported by management.

• The practice proactively sought feedback from staff and patients, which it acted on. However, the practice did not have a patient participation group in place despite several attempts to set up one.

We saw one area of outstanding practice:

The practice was proactive in identifying and providing services for people whose circumstances may make them vulnerable closer to home. For example:

• The practice delivered the second largest weekly substance misuse management clinic in Nottingham and this was accessible to registered and non-registered patients. Patients benefited from integrated care as this clinic was delivered with input from a specialist substance misuse worker. Practice staff had received extra training to ensure patients were able to receive more complex treatment at the practice.

• The practice provided primary medical services to patients enrolled in a rehabilitation programme to address their drug and alcohol addictions. In addition to removing barriers for these patients to access services at the practice, they undertook home visits. This service was provided at no extra funding and had improved outcomes for patients.

The areas where the provider should make improvement are:

• Continue to make attempts to set up a patient participation group within the practice.

• Ensure carers are proactively identified and offered services that improve their care.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Patients’ needs were assessed and care and treatment was planned and delivered in line with their individual care and treatment plan.

One patient told us, “Everything’s been fine. I’m given time to discuss my concerns and I’m not hurried up.” A second patient said, “My care and treatment’s been excellent.”

Medicines were kept safely and stored appropriately.

The provider had a proactive approach to training for clinical and non-clinical staff and ensured staff had adequate time provided in order to complete relevant training and continuous professional development.

We spoke with five staff members and they all confirmed they felt supported by the practice manager and GPs at the practice.

One staff member said, “It’s a good practice. We’re trying to make things better for the patients.”

The provider had ensured the quality of service provision had been appropriately assessed and managed in order to meet the needs of patients registered with the practice. One relative said, “I’m happy overall.”