Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Doc's Surgery on 21 June 2016. Overall the practice is rated as outstanding.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, the practice developed a Caldicott Guardian role responsible for all patient information requests, to ensure all summary care record and HIV (HIV means Human Immunodeficiency Virus, which attacks the body's immune system) positive patients were dealt with in a timely and effective manner.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they met local patients’ needs. For example the practice treated a small number of older Chinese patients and forged close working with a local organisation to help with translation services and support network.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff. This included clinical discussions daily every lunch time and formal clinical meetings.

• The practice had an established partnership with multiple healthcare professionals and research projects to facilitate and improve patient outcomes. For example the practice had been involved in the research into primary care missed diagnostic opportunities.

• The practice had strong and visible clinical and managerial leadership and governance arrangements.
• Feedback from patients about their care was consistently positive.
• The practice had good facilities and was well equipped to treat patients and meet their needs.

We saw areas of outstanding practice including:

• The practice offered a full in-house sexual health clinic to registered and non-registered patients. This included same day results for HIV testing and a full screening and treatment service, something which is normally offered in sexual health clinic. The practice had the highest number of patients with HIV in the UK. It had established close links with one of the HIV consultant at North Manchester Hospital and a joint clinic was held once a month. The practice had developed a “Man fact sheet” on raising the awareness of Human Papilloma Virus (HPV is the name for a group of viruses that affect your skin and the moist membranes lining your body).This was already showing to be a positive tool in raising awareness. One example, saw a high risk patient receiving the full course of vaccines so far. There was also an expressed interest in being involved in a pilot project at primary care level.
• The GP partner had started an emotional wellbeing initially called “yoga on prescription” scheme to help support the high number of patients who suffered from acute illness such as stress, anxiety, low mood and generalised pain. . Between February and June 2016 there had been 27 patients issued a yoga prescription. The lead GPs presented the scheme to the House of Lords on 27th June 2016.
• The GP partners had been using supervision meetings every 6-8 weeks for many years, which are held as counselling sessions. This had been an invaluable tool to help shape and develop strong clinical support and manage the successful business side of the practice. Any new partners must agree to attend these meetings.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice