Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Robin Lane Health and Wellbeing Centre on 29 June 2016. Overall the practice is rated as outstanding.

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

• There was an open and transparent approach to safety. Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning were maximised.
• Risks to patients were assessed and well managed. There was a comprehensive risk register in place (quality assurance document) which identified risks, actions to mitigate the risk and what review arrangements were in place.
• Infection prevention and control was a regular agenda item at the practice meetings.
• All patients had access to extensive facilities and support groups, which were available at the Health and Wellbeing Centre.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, the provision of ophthalmology services and the elderly care pathway.
• Patients’ needs were assessed and care was delivered following local and national care pathways and National Institute for Health and Care Excellence (NICE) guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Patients had good access to appointments and telephone consultations, which included appointments during extended hours; early morning, evenings and on Saturdays.
• The practice also conducted an annual outreach programme. This was to seek out patients across Leeds who were not currently registered with a GP practice and ensure they received appropriate care, treatment and support.
• There were strong and visible clinical and managerial leadership and governance arrangements in place.
• The practice proactively engaged with their patient population and stakeholders regarding the delivery and development of services.

We saw several areas of outstanding practice:

• The practice had developed a Care of the Elderly pathway, aimed at those patients who were housebound, at a high risk of hospitalisation or residing in a care or nursing home. This pathway had been shared and implemented across other Leeds practices. They had developed an ‘elderly care team’ and as a result the practice could evidence a 23% reduction in unplanned hospital admissions and an 80% reduction in urgent home visits for this population group.
• There was a walk-in service for all routine or urgent health matters, which ran from 8am to 4pm Monday to Saturday each week. There was evidence to support that there had been an overall reduction in A&E attendance by 10% and an overall reduced demand for appointments in the usual bookable clinics by 26%.
• The practice had developed the health and wellbeing centre where patients and members of the local community could attend. Facilities included an onsite café, arts events, a variety of support groups and over 60 free volunteer run activities.
• The practice promoted sharing and learning and linked with a number of organisations in this country and around the world to use best practice to develop their services. This was evidenced in the number of organisations who had approached the practice to share their innovative approach to primary care, such as the smartphone app, elderly care pathway and the formation of the health and wellbeing centre.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice