Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Chislehurst Medical Practice on 23 August 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 a system in place for reporting and recording significant events; however we found some incidents that could have been classed as significant events which may have led to further learning.
• Risks to patients were assessed and well managed.
• 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.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available 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 and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.

There was one area of outstanding practice:

• The Bromley borough was first in Europe to pilot a diabetes prevention programme for obese patients where these patients were referred to an intensive lifestyle intervention delivered by a private provider. Out of the 14 practices which participated in Bromley the practice had the highest number of referrals (28 patients; 17% of total referrals) with an uptake of 89% (25 patients). Following the programme eight patients (38%) were no longer at risk and nine patients (43%) had reduced their risk. Due to the success of this programme Bromley (along with 12 other South London boroughs) was the first area in the UK to roll out the National Diabetes Prevention Programme.

There were areas of practice where the provider should make improvements:

• Review practice policies and procedures to ensure where appropriate, incidents are considered as significant events and that the recording of significant events is improved.
• Review practice procedures to ensure there is a system in place to monitor implementation of medicines alerts.
• Review practice systems to ensure that lessons are learned from complaints and that they are shared with all relevant staff.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice