Due to the nature of the service, we were unable to talk directly to people using the service. However we did see a wide range of feedback from people, all of which was positive. The provider is registered for a number of regulated activities. However, during our visit we did not see any information relating to the regulated activity maternity and midwifery servies.

The provider demonstrated an excellent use of information technology by using an electronic care system. This system was a live system and staff had instant access to it via their portable computers. This system meant that the staff had instant access to patient details, policies and procedures. Once they had provided care, the system was updated instantly.

The provider had a comprehensive governance system in place and regularly audited the clinical practice of its medical and nursing staff. We were able to see a range of feedback from people who had used the service. All had been positive and included “Thank you for the support and care you provided. I just wanted to express my deepest appreciation”. “The care and kindness I received was exceptional and I can't thank you enough, its a wonderful service and very reassuring” and “thank you for all your help and kindness.”

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Principal Medical Limited on 21 and 22 March 2017. Principal Medical Limited is a GP federation providing specific services for the majority of GP practices in Oxfordshire and also South Northamptonshire. It has been owned by GPs since being created in 2004 and is run by a variety of clinical and non-clinical staff. They deliver services via associated member GP practices by sub-contracting services or directly via employed staff. Overall the provider is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open culture of learning and the provider enabled their services to be dynamic in their design and delivery.
• There was an open and transparent approach to safety and a system in place for reporting and recording significant events. However, due to the difficulty in gathering all staff groups for meetings at one time, sharing of outcomes was not always formalised. There was good alternative communication.
• The provider had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained and provided with the skills, resources and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke, those who left feedback and survey data showed that the level of satisfaction among those who used the service was high. This included access to staff, communication and the quality of services received.
• The provider ensured there were the required facilities and equipment to enable staff to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The provider proactively sought feedback from staff and patients, which it acted on.

• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the provider complied with these requirements.

The areas where the provider should make improvement are:

• Review the processes for ensuring relevant staff receive learning outcomes from significant events.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice