Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Prospect Medical Practice on 13 October 2015. 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;
• Risks to patients and staff were assessed and well managed;
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and responsibilities;
• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand;
• Patients said they were treated with compassion, dignity and respect and were involved in decisions about their care and treatment. Results from the national GP Patient Survey showed patients were satisfied with the quality of the care and treatment they received from their GPs and nurses;
• Most patients expressed no concerns about access to appointments. Whilst the practice performed well in most areas covered by the survey, their performance fell considerably below that of the local Clinical Commissioning Group (CCG) and national averages in relation to telephone access to the practice, access to appointments, and appointment waiting times. We found the practice was aware of this and were constantly adjusting the resources they had available to them to make their telephone and appointment system more responsive;
• There was a clear leadership structure and staff felt supported by the management team. Good governance arrangements were in place;
• Staff had a clear vision for the development of the practice and were committed to providing their patients with good quality care.

We saw several areas of outstanding practice including:

• The practice had also collaborated with a local advocacy service, and representatives of local black and ethnic minority communities, to produce a leaflet to help patients understand how to use the services provided by the practice;
• Over 50% of patients registered with the practice were people whose first language was not English. We saw the practice had taken steps to make their service accessible to this group of patients. For example, 1387 interpreter sessions had been arranged during the previous six months. Reception staff also had access to prompt sheets in some languages, to help them assist patients to explain their reasons for attending the practice. Work was underway to extend the range of languages covered by the prompt sheets. Staff were in the process of setting up a system to translate standard practice letters into a range of other languages to help promote better patient communication. A facility on the practice’s website enabled patients to obtain translations of each web page in a language of their choice. The practice had recruited two GPs who spoke some of the Indian Sub-Continent languages. The arrivals screen provided patients with information in a range of languages. The practice did not have a hearing loop system, but steps were being taken to have one installed. Information on the practice website informed patients that they could book an interpreter by contacting reception staff. Reception staff were clear about the arrangements for accessing interpreters and we saw this happen during the observation we carried out in the reception area.

The areas where the provider should make improvements are:

• Complete fire drills at the frequency outlined in the practice’s fire risk assessment;
• All staff who undertake chaperone duties should receive appropriate training;
• Develop a more proactive and structured approach to identifying topics for clinical audit;
• Continue to monitor and review the effectiveness of the practice’s appointment system to ensure it remains responsive to patients’ needs.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice