Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Mythe Medical Practice on 22 November 2016. Overall the practice is rated as outstanding.

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, staff demonstrated a detailed knowledge of learning from previous events.

• Feedback from patients about their care was consistently positive. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• 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.
• 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 (PPG). For example, following a cease in funding for an NHS acupuncture clinic the practice and PPG worked collaboratively to source new funding to ensure the service could continue.
• The practice had good facilities and was well equipped to treat patients and meet their needs. Due to a growing population and a recent merger the practice had secured new purpose built premises that they were due to relocate into by the end of 2016.
• 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 strong and visible clinical and managerial leadership and governance arrangements.

We saw several areas of outstanding practice including:

• The practice had trialed and continued to use a new model to manage non urgent paediatric outpatient referrals in Tewkesbury. Multi-agency paediatric hub team meetings were arranged on a monthly basis to discuss and plan care for children. The hub meetings enabled access to specialist advice within four weeks as opposed to waiting up to 12 weeks for a referred appointment. Due to the multi-agency representation the meetings reduced multiple referrals and inappropriate referrals. Each meeting was concluded with interactive teaching and reflections on learning.

• A practice GP was instrumental in developing the ‘Big Six’, which was a pathway toolkit designed to ensure clinicians offered appropriate and high quality care when children presented for emergency care for one of the six main clinical areas (bronchiolitis/croup, fever, gastroenteritis, head injury, asthma or abdominal pain). This pathway was actively used in practice, adopted by the local commissioning group (CCG) for use in locality practices and adopted by other CCGs in England.

• The practice had been recognised as being one of ten exemplar practices in England for supporting carers. An article was published detailing how these practices had identified and supported carers, which other practices could learn from. The practice had developed a carers group, met monthly and invited speakers to support and educate as required. All carers were invited for annual health checks. Carers worked with the PPG to improve patient care.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice