Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hope Citadel Healthcare CIC on 23 September 2016. 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.

• Feedback from patients about their care was positive.

• The practice implemented suggestions for improvements as a consequence of feedback from patients and from the patient participation group (PPG).
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice held several community groups on their premises and was actively involved in running most of them.
• The practice actively reviewed complaints and how they are 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.
• The practice encouraged their staff to develop and progress. For example reception staff had been trained to be team leaders and practice managers within the organisation and the healthcare assistant had recently been accepted into medical school.

We saw several areas of outstanding practice including:

• The practice was instrumental in setting up various social and community groups to suit the needs of their patient population. The importance of social interaction, and the high cost of joining social groups potentially making them unaffordable for patients had been recognised. The practice carried out evaluations of the groups and found patients found them very beneficial. Groups included:

  • BLISS (Believe Love Inspire Self-worth Support), for young isolated mothers, initiated by reception staff. An evaluation had been carried out and outcomes had been positive for patients attending. A counsellor from the practice attended the group once a month.

  • Mucky Monkeys; a group for young children and their parents, initiated by The Salvation Army and run by a members of the reception staff.

  • Inspire; a social group for older patients and the retired.

  • Hill Top Growers; a gardening group initially set up for diabetic patients but all patients could join in. This encouraged healthy eating and exercise.

  • Healthy Lifestyles; a group where weight could be monitored and patients could join in with group walks and exercise.

• The practice was closely involved in a community café, The Brew, based across the road from them. Patients living in social isolation were supported to attend the café, and where patients were looking to learn new skills or start work they arranged for them to have work experience in the café. This gave them experience, confidence, and the opportunity for a reference for when applying for jobs.

• The practice employed a focussed care practitioner. The focussed care practitioner looked after the holistic needs of patients who were referred by the GP. Needs were wide-ranging and included family issues, alcoholism, sexual exploitation and sleep problems. The focussed care practitioner saw patients on a regular basis when this was needed and put plans in place involving other organisations, such as the job centre or housing department, to ensure individual needs were met. There was regular evaluation of this service with evidence available of progression made by patients seeing the focussed care practitioner. We spoke with two patients who told us how seeing the focussed care practitioner had had a positive impact on their lives.

• The practice employed in-house counsellors so they were easily accessible to patients. Staff were also actively encouraged to use the counselling service if they felt it was required.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice