Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Langley Health Centre, Common Road, Langley, Slough, Berkshire, SL3 8LE on the 12 May 2015. This was the first inspection under the new CQC comprehensive inspection approach and was undertaken to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The practice demonstrated a commitment to continuous improvement through learning and responding to patient feedback and we have rated the practice overall as outstanding. The ratings underpinning this are provision of outstanding effective services and outstanding for being well led. The practice is rated as good for the delivery of safe, responsive and caring services.

The provider has a second practice located in Colnbrook. We did not inspect this service because it is registered separately with the CQC.

Our key findings were as follows:

• The practice had robust systems in place to safeguard patients from potential abuse. Staff were appropriately trained in safeguarding and one GP was the safeguarding lead for the CCG. Learning from safeguarding board meetings and child protection reviews was disseminated widely within the practice.
• Systems to safely manage medicines and reduce the risk of cross infection were operated.
• A range of appointments were available including clinics on both Saturday and Sunday each week. However, some patients were not aware of the availability of these appointments.
• The practice was committed to learning from complaints and other recorded incidents. Complaints were dealt with in a comprehensive manner and learning from them was shared with the practice team.
• Learning from incidents was shared with both staff and other practices in the area. The practice took an active role in the local health community and constantly strove to expand and improve the services it offered.
• The practice was aware of, and actively sought, patient feedback. There was evidence that the practice took action to address patient feedback. A new telephone system had been installed in 2014 to assist in answering calls more rapidly and online booking of appointments was in place.
• Patients we spoke with and CQC comment cards completed reported that staff were kind and caring and that reception staff were polite and professional. The practice had invested in customer care training for reception staff.
• The practice had a clear vision which placed learning, quality and safety as top priorities. The plan was monitored and shared with staff and the patient participation group. High standards were promoted and owned by the practice team.
• Completion of two cycle audits that identified actions to improve patient care and outcomes and evidence that improvements were achieved. For example, prescribing of a combination of two medicines which had the potential to interact was audited twice and the number of patients taking both medicines had reduced by 46%.

We saw several areas of outstanding practice including:

• The practice was open seven days a week providing access to appointments on both Saturday and Sunday. The weekend clinics were shared with another local practice.
• The practice had a clear vision, a strong learning culture and was committed to continued quality improvement. Quality improvement was supported by taking a community wide approach to health in bringing learning back to the practice from and sharing information with the CCG. The practice risk register was supported by use of a risk stratification tool.
• An open approach to seeking patient feedback and acting upon it. Open evenings held in conjunction with the Patient Participation Group enabled patients to bring any issues to the attention of the GPs and management.
• The practice had an open culture in sharing learning. This included liaisons with neighbouring practices to share information about significant events and rare presentations of clinical conditions.
• When complaints were received relating to quality of consultations experienced GPs coached other members of the team in good consultation techniques and there had been no further complaints since the coaching session.

There is an area where the provider should make improvement and this is:

• Improve the promotion of the availability of extended hours surgeries to ensure all patients are aware of these.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice