This practice is rated as Good overall. (Previous rating May 2015 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Market Street Medical Practice on 19 June 2018 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 one area of outstanding practice:

The practice initiated an E-consultations system in April 2017 for patients which was accessed securely via the practice website in which patients could start a consultation with a GP 24 hours a day seven days a week and get a response within 48 hours. Initial evaluations from both the practice and patients were positive and provided flexibility for both patients and clinicians. They had seen the number of e-consultation requests being processed increasing month on month. We noted from data provided by the practice for example in May 2018, 26 consultations were carried out, saving approximately 15 face to face consultations. Feedback from patients who used the service was positive, all stated they were very satisfied with the service and they would recommend to friends and family.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Market Street Medical Practice on 9 April 2015 2015.

Overall the practice is rated as good.

Specifically, we found the practice to be good for providing, safe, effective, caring, and well led 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. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and managed.
• Patients’ needs were assessed and care was planned.
• 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 could make an appointment with a named GP, with urgent appointments available the same day.
• The practice was equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management.

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

The provider should:

• A programme of more frequent clinical audits should be developed to demonstrate positive outcomes for patients.
• Pre-employment checks should be in place before staff are employed.
• NICE best clinical guidance should be followed, for example, the review of warfarin.
• A planned programme of staff appraisals should be developed for clinical and non clinical staff.

• All staff clinical and non clinical should complete updated training in safeguarding children and adult protection appropriate to their role within the practice.
• All staff clinical and non clinical should complete training in infection control and basic life support.
• The practice should develop a medicines cold chain policy.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice