Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Sherrington Park Medical Practice on 7 March 2016. The overall rating for this practice is outstanding.

Our key findings were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events, and we saw evidence that learning was applied from events.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Feedback from patients about their care, and their interactions with all practice staff, was consistently and strongly positive. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Patients said they found it easy to book an appointment with a GP, and routine appointments could also be booked up to six months in advance. Urgent appointments were available the same day.
• The two GPs held their own patient lists to ensure continuity of care and establish strong relationships with patients and their families.

• The practice used clinical audits to review patient care and we observed how outcomes had been used to improve services as a result.

• The practice worked effectively with the wider multi-disciplinary team to plan and deliver effective and responsive care to keep vulnerable patients safe. This approach had impacted on unplanned hospital admissions and attendance at Accident and Emergency.
• There was a strong and proactive leadership structure within the practice, and staff felt well-supported by management.
• The practice had good facilities and was well-equipped to treat patients and meet their needs.
• The practice reviewed the way it delivered services as a consequence of feedback from patients.

We saw several areas of outstanding practice including:

• The practice provided excellent access to GP appointments. This was reinforced by the national GP survey results. For example, 89% of patients described their experience of making an appointment as good compared to the CCG average of 74% and national average of 73%. Patients we spoke to on the day of the inspection also highlighted the ease of making an appointment to see a doctor. The practice had low attendance rates at Accident & Emergency (220 per thousand population compared against the local average of just above 300), and a lower number of unplanned hospital admissions in comparison to other local GP practices (53 patients per thousand population versus the local figure of 90), demonstrating that good access achieved positive outcomes for patients.

• The practice worked in collaboration with other practices. For example, reviewing and learning from incidents; peer review meetings; and arranging and hosting monthly presentations from locally based professionals – for example, a consultant in chest related diseases had recently spoken to the group.

• In response to a lower rate of diagnosis, the practice had introduced a more comprehensive assessment tool to identify patients with dementia, and implemented an alert for patients at risk of developing dementia on the clinicians’ computers. This had helped identify more patients with dementia to enable them to receive treatment and support at the earliest opportunity. The diagnosis rate had increased from 35.2% to 48.5% to bring this in line with the local average of 55%. The use of the new screening tool had identified three new patients with dementia in the first two months of its implementation, who would not have been identified using the standard assessment tool.

In addition the provider should:

• Strengthen the infection control lead role by defining key responsibilities, and ensuring additional training is undertaken to support this role.
• Review the relationship with the Patient Participation Group (PPG) to ensure they provide a voice for patients, and are influential in shaping service provision.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice