Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Newport Pagnell Medical Centre on 27 September 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.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, we saw evidence of an asthma protocol developed by the Respiratory Lead Nurse which was shared with the CCG and was then shared for use across the locality.
• Services were tailored to meet the needs of individual patients and were delivered in a way to ensure flexibility, choice and continuity of care.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice actively reviewed complaints and how they were managed and responded to, and made improvements as a result.
• The practice had a clear vision with quality and safety as its top priority. High standards were promoted and owned by all practice staff and teams worked together across all roles.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw several areas of outstanding practice including:

• The practice shared significant events with the Milton Keynes Clinical Commissioning Group (CCG) serious incident learning and review forum to share learning and improvements across the locality. The CCG used the data from the shared significant events to identify trends and areas of learning which were then shared across the locality to encourage improvements to standards of care.
• The practice ran a weekly drop in leg clinic, led by the practice nurse and district nursing teams. The clinic provided a holistic approach to care and aimed to support patients wholly rather than just focusing on their leg treatment needs. Mental health needs and the impact of a patient’s condition on their general quality of life was also considered and supported accordingly. The practice had reviewed the effectiveness of this service through audit and had identified that wounds were fully healed within four months for 80% of patients seen at the clinic.
• The practice was classed as a POCT (point of care testing) hub practice within the locality, and alongside six other practices was offering patients additional services not normally found within a GP setting. For example, the Newport Pagnell Medical Centre was able to offer NT-BNP (for the early diagnosis of heart failure) and D-dimer testing for patients. (D-dimer tests are used to rule out the presence of a blood clot).
• The Community Matron provided a weekly Carers Clinic providing carers with an opportunity to receive dedicated care and support. All carers were invited to attend for health and stress checks and where needed provided with care plans. In addition the Community Matron facilitated an open Carers Group at a local community hall, where carers of patients suffering with dementia could take their dependants and meet others in similar positions to themselves. This group was open to carers from across the locality.
• The practice facilitated an annual practice conference, bringing together all members of the practice. This was seen as an invaluable opportunity to ensure that all staff were included in the future planning of the organisation. Individual teams presented their work and achievements over the preceding 12 months, before presenting their strategic plans for the upcoming year. These individual team plans were then used to develop the overall strategic plan for the organisation, demonstrating a forward thinking culture of inclusion, equality and excellence.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice