Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Moulton Surgery on 25 October 2016. Overall the practice is rated as good.

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.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, they had produced a comprehensive quality monitoring policy with positive engagement and consultation with patients, relevant local services, local Federation of GP services and Northamptonshire Clinical Commissioning Group (CCG). The policy covered all aspects of the practices work, including assisting patients in making informed plans about end of life care, cancer referrals and a proactive approach to monitoring and review of high risk medication. Implementation of the policy had been rolled out across the area at meetings with patients and other residents in the area to help raise awareness of healthy lifestyle choices.
• The practice had a branch on the campus of Northampton University since 1973. The make-up of the practice population at Moulton Surgery is influenced by the approximate 3,500 students who register whilst they study at Northampton University and Moulton College.
• Feedback from patients about their care was consistently positive. We received 46 comment cards completed by patients. All of the cards contained positive feedback about the quality of care and the compassion of staff who delivered services.
• 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 the practice had built and maintained effective positive relationship with the parish council with representatives from the council also serving on the Practice Patient Participation Group. The practice was fully involved in consultation, planning, design and development of a new Health and Wellbeing centre to meet growing demand of the increasing population.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group. For example, feedback from local patient surveys supplemented findings from the annual national GP patient survey was presented to partners and all staff meetings.
• We saw clear evidence that patient feedback drove improvements to the practice. The practice has worked with other agencies to help address social exclusion for example they had facilitated a ‘healthy walking’ group, had obtained an allotment plot and supported a voluntary car driver scheme to help patients attend the practice or for other health related needs.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• 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 produced a comprehensive vision for the development and implementation of a Health and Wellbeing strategy for the residents of the village and surrounding area.
• The practice had strong and visible clinical and managerial leadership and governance arrangements. A three year business plan and strategic development plan had been developed and produced to guide the direction and growth of the practice as it prepared to move in to new purpose centre.
• Strategic planning was at the core of development work for the delivery of excellence to patients by staff who were encouraged and supported to embrace opportunities for their own personal improvement.

We saw one area of outstanding practice;

• The practice had created a Proactive Care Scheme for patients entering the palliative care phase of their illness and for patients resident in a local nursing care home. This scheme encouraged a multidisciplinary and collaborative approach and evidence showed this had a positive impact on the care patients received.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice