Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Kirkstall Lane Medical Centre on 10th March, 2016. Overall the practice is rated as outstanding.

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

• There was an open and transparent approach to safety and a robust and effective system in place for reporting and recording significant events.
• The provider was aware of and complied with the requirements of the Duty of Candour.
• 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.
• 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 used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice for example the Care Home project.
• Feedback from patients about their care was consistently and strongly positive.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs.  For example they worked with the local charity that provided accommodation for people who had been involved in people trafficking and human rights abuses.
• The practice implemented suggestions for improvement and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group. Examples of this were, the changes made to the services provided to mothers and their children after consultation, and the extended hours service of 7am-7pm daily and input into the ‘Hub’ arrangements.
• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about services and how to complain was available and easy to understand
• 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, was prominently displayed in the waiting room and was regularly reviewed and discussed with staff.
• There was a clear leadership structure with devolved responsibility and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

We saw several areas of outstanding practice including:

• The practice provided a same day service, when needed, for patients who are survivors of human rights abuses and extended appointments were available to support the use of the interpreter services.  There was a lead GP identified for this group of patients,who had made contact with other providers of services to this group, and who had visited the residences to gain a broader understanding of the care that was needed.  This had resulted in the delivery of a need and evidence based, targeted service for this particular group of vulnerable patients.
• The practice had developed and implemented a ‘dispersed management’ model which devolved power and empowered staff to make decisions and change working practices. This had resulted in staff feeling valued, motivated and involved in the practice.  It also meant that improvements and changes were implemented promptly.
• The lead GP for care homes had a dedicated weekly session to proactively review care home patients and spend focussed time agreeing with each person (and their families) preferred approaches to their care and ensured this was documented and agreed with care home staff.
• A protocol that helped practice staff to recognise and assist carers had been developed by the practice.This ensured that carers were routinely checked and offered support.

However there were areas of practice where the provider should make improvements:

• Recording and updating of Hep B status for all members of clinical staff.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice