Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Sett Valley Medical Centre on 21 July 2016. Overall the practice is rated as outstanding.

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

• There was an effective system in place for the reporting and recording of significant events. Learning was applied from events to enhance the delivery of safe care to patients.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. An ongoing programme of clinical audit reviewed patient care and ensured actions were implemented to improve services as a result.
• The practice planned and co-ordinated patient care with the wider multi-disciplinary team to deliver effective and responsive care to keep vulnerable patients safe.
• The practice was committed to staff training and development and the practice team had the skills, knowledge and experience to deliver high quality care and treatment. The practice had an effective appraisal system in place.
• There was a good staff skill mix in place which included three nurse practitioner roles. The practice also contracted a pharmacist and a community matron to provide weekly sessional input at the practice.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. The practice analysed and acted on feedback received from patients.
• Patients provided generally positive views on their experience in making an appointment to see a GP or nurse.
• Longer appointments were available for those patients with more complex needs. An advanced nurse practitioner triaged calls and ensured that any patient requiring an urgent appointment was seen on the same day.
• The practice had good facilities and was well-equipped to treat patients and meet their needs.
• There was a clear leadership structure in place and the practice had a governance framework which supported the delivery of good quality care. Regular practice meetings occurred, and staff said that GPs and managers were approachable and always had time to talk with them.
• The practice had a clear vision for the future and included the practice team in reviewing and planning service delivery. The aspirations of the partners were in line with the CCG strategy of delivering high quality care closer to the patient’s home.
• Information about how to complain was available upon request and was easy to understand. Improvements were made to the quality of care as a result of any complaints received.

We saw the following areas of outstanding practice:

• The practice had worked in collaboration with the UK Sepsis Trust over the last 18 months to promote the awareness and treatment of sepsis in primary care. This recognised that the early identification of symptoms and the use of effective safety netting was paramount within the primary care setting. This had led to the publication of an article written by the advanced nurse practitioner in the British Journal of General Practice in March 2016. A second project was underway to assess GP perception and knowledge of sepsis prior to the publication of NICE guidance on sepsis in July 2016. The ANP and GPs delivered training on sepsis to other primary care colleagues within their area, and aspired to influence a national sepsis promotional campaign.

• The practice was located in a semi-rural location and had configured its services to be responsive to the needs of their own patients and the wider patient community. For example, the practice provided a vasectomy service which enabled patients from other practices to receive this service, and to improve patient choice and access to local treatment.

The areas where the provider should make improvement are:

• Develop cleaning schedules to determine the extent and frequency of cleaning for each room, and review how this will be monitored.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice