Letter from the Chief Inspector of General Practice

This practice is rated as Outstanding overall. (Previous inspection April 2015 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Outstanding

Are services well-led? - Outstanding

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Outstanding

People experiencing poor mental health (including people with dementia) - Outstanding

We carried out an announced comprehensive inspection at Haughton Thornley Medical

Centres on 6 December 2017 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw several areas of outstanding practice including:

• The practice and PPG were proactive in encouraging patients to sign up to have full online access to their medical records. We saw to date the practice have 62% of patients signed up for access. The practice were in the process of evaluating the impact and monitoring usage to assess the benefits to patients and the practice.
• The PPG in partnership with Hyde Community Action ran an ESOL course (English for Speakers of Other Languages) with a health theme for 16 female patients in which they taught them how to access a GP and other health services, how to sign up for online services, medical records access and how to use “My Medication Passport”. Evaluations of this project showed, by the end of the course, 100% of the women reported increased confidence, knowledge, awareness of online access to health records, healthy eating, exercise, pharmacy and other local services and they shared the information with their family and friends.There was a waiting list of 60 patients for future courses.
• The practice secured funding in 2015 for the Hyde Healthy Living project which was to benefit all patients over 75 years of age across the neighborhood including those registered with other practices. Although the formal funding for the project ended in August 2017 the practice had maintained the social prescribing, additional GP time, and the pharmacist and were working with the local Health and Well-being team to co-ordinate future reviews. Evaluation of the programme to date showed 102 patients and their carers benefitted from the programme and their goals were monitored and outcomes measured using a nationally recognized evaluation tool. We saw from the evaluation, following intervention 53% said they felt more positive, 56% were managing their symptoms. Outcomes for individuals included a review of benefits received, disability badges issued, stair lifts and mobility aids being fitted to help prevent falls and support to attend social events. Hyde Healthy Living Project was awarded the BMJ Primary care team of the year 2016.
• Following on from the Healthy Hyde project have integrated social prescribing pathways and templates into the clinical system allowing staff to quickly refer patients for additional support in the community where required, for example to Age UK and the community response team. Data provided by the practice showed 180 social referrals were made by the practice, meaning a quicker more streamlined system for patients

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Thornley House Medical Centre on 28 April 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing well-led, effective, caring, responsive and safe services. It was also good for providing services for the populations groups we rate.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand, however there was no evidence of the system being put into practice.
• Patients provided varied feedback on accessing appointment, with a number of patients reporting difficulties getting through to the practice by telephone, however patients reported when they got appointments these were convenient.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management.

We saw several areas of outstanding practice including:

• The practice offered patients direct electronic access to their health records enabling them to routinely read their own health records by logging on to an electronic system from home with a user name and password. To date 35% of patient have signed up to allow them access to their records.
• One GP provided dry needling a treatment similar to acupuncture for patients during consultations to provide pain relief and assist injury rehabilitation where required as an alternative or in addition to medication.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should

• Ensure recruitment checks are carried out in line with practice policy.
• Ensure all staff have access to appraisals on an annual basis.
• Ensure data sheets and risk assessments are carried out for Control of Substances Hazardous to Health (COSHH).
• Ensure checks are recorded for the cleaning of clinical equipment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice