Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at St George’s Medical Centre on 24 March 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• The practice hosted various services on site to ease access issues for patients and local people in their area and sourced various equipment using the funds raised by a charity group.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Urgent appointments with a GP were available on the same day.
• The GP Patient survey results were in line with the local and national averages.
• Information about services and how to complain was available and easy to understand.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management.
• The practice proactively sought feedback from staff and patients, which it acted on.
• The practice was aware of and complied with the requirements of the Duty of Candour.

Areas of outstanding practice are;

• In 2008 the practice initiated an in house outpatient clinic including surgical procedures for a local general hospital who used the room rent free. The partners funded the room specification changes needed, to meet the required standards to have an operating room within the practice.The practice charged the hospital an administration charge for the up keep of the services provided which included rates/ cleaning/ management/ etc.The services provided included; ophthalmology (conditions relating to the eye), urology (conditions relating to the urinary system), gynaecology fertility service (conditions relating to the female reproductive system) and general surgery. The hospital provided the staff to the clinic.The clinics and operations were Consultant led.Patient response to the ongoing service has been positive.

• The practice housed an oncology outreach programme for the local hospital in Cambridge for the past two years. The practice recognised that patients found it difficult to attend the local hospital for chemotherapy treatment and gained permission to set up the unit. The practice sourced the funds to set up the unit privately and offered the room to the hospital for a charge of £10 per day and the remainder of the annual running costs were funded by a charity group called patients and users lenders of special equipment (PULSE). The practice received a large donation from a local business to set up the cancer suite. The unit benefitted the nine other practices in the locality and worked jointly with the specialist oncology nurses. In the past two years approximately 1200-1400 patients had attended the outreach programme. The hospital provided the staff for the outreach programme.
• The practice had sourced a bladder scanner (a device to identify the residual amount of urine in the bladder) from the PULSE. The practice explained that it saved time, money, hospital admissions and referrals for patients to the continence clinic.

The areas where the provider should make improvements are;

• Review the information displayed in the waiting room.
• Fire procedure training should be undertaken by all staff.
• Consider strengthening the records maintained to show what training staff have received and what is still required.
• Take more proactive steps to improve breast and bowel screening rates and to review exception reporting for some clinical indicators.
• Ensure the practice is proactive in identifying carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice