Letter from the Chief Inspector of General Practice

We visited Maple Access Partnership on the 6 October 2014 and carried out a comprehensive inspection. The practice offers a satellite clinic at Oasis House, which is a homeless support centre but we did not inspect that venue.

The overall rating for this practice is good, with areas of outstanding practice for vulnerable groups of people, which includes substances misusers and homeless people, as well as those with mental health needs where the practice has a special interest and has developed tailor made services for their patients.

Our key findings were as follows:

• Patients were satisfied with the service and felt they were treated with dignity, care and respect and involved in their care.

• There were systems in place to provide a safe, effective, caring and well run service.

• There was a good understanding of the needs of the practice population and services were offered to meet these.

We saw areas of outstanding practice including:

• The practice’s approach to mental health and services for vulnerable people, including the homeless and substance misusers. They had developed a specialist, non stigmatising service which provided easier access and support for patients who had difficulty in accessing health services or were in crisis. The practice had developed relationships with other agencies to build services and ensure that patients accessed the appropriate support when they needed it and so that all professionals involved in care were aware of the issues facing this vulnerable group of patients.

• The practice offered specialised satellite clinics four times a week at a homeless support centre and worked with the local agencies, such as the local council, police and other agencies of support. This facilitated development of a co-ordinated approach and provided patients with access to care when they needed it. They offered a drop in session daily for people who misused drugs to allow them to access help if in crisis.

• They had developed different means of communication to help patients remember to attend appointments, such as text reminders and had also introduced a means of allowing hearing impaired patients to book their appointments by text messaging.

However, there were also areas of practice where the provider should make improvements.

The provider should:

• Ensure their clinical audit process is scheduled, completed and includes minor surgery complications including coils and contraceptive implants.

• Ensure that any staff who may at any time be required to act as a chaperone has received the appropriate training.

• Document that any non-clinical staff who had not received a Disclosure and Barring Service (DBS) check had been risk assessed before commencing employment.

• Ensure that all policies and protocols are updated and reflective of practice that staff should carry out.

• Carry out minor repairs in the treatment room as identified in this report.

• Amend the Controlled Drug policy to include instructions for circumstances when patients may bring in their controlled drugs for administration.

• Review their policy regarding texting patients with results to account for when young people become 17 years of age. Currently there is no system to ensure a change or review of young peoples’ contact telephone numbers when they reach the age of 17 as prior to this age they are often registered with their parents contact number. This may result in a breach of confidentiality.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice