Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Leys Health Centre on 24 February 2016. Overall the practice is rated as good, improvements are required in providing responsive services.

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.
• Medicines were managed safely.
• 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.
• National data suggested patients received their care in line with national guidance.
• 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 difficult to make an appointment with a GP.
• 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.
• Governance arrangements were in place for non-clinical aspects of the service.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We found one area of outstanding practice:

• The practice considered and went beyond its contractual obligations in providing support to some its most vulnerable patients. For example:

  • The practice had led on a scheme to provide mentoring to young patients (16-24) who were encountering social or personal problems, potentially at risk of developing mental health issues. The practice referred patients onto the project during the initial pilot in 2015 and this has been extended due to the feedback from those involved. Patients provided feedback and we were shown case studies where patients reflected positively on the scheme. Outcomes included better social contact, long term planning to meet needs and greater independence in tackling problems.
  • Staff worked with patients who they were aware had problems associated with poor housing conditions, including working with external organisations to try and improve these patients physical and mental wellbeing.
  • Staff identified that some patients did not find leaflets on their care and treatment easy to use. Therefore nurses developed pictorial guides along with written guidance on the practice leaflets for diabetes and asthma care.

The areas the provider must make improvements are:

• Ensure the appointment system and appointment availability enable patients to book appointments in a reasonable timeframe.

Areas the provider should make improvements:

• Ensure nurses are aware of the principles and requirements of the Mental Capacity Act 2005
• Review means to increase in the uptake of learning disability health checks.
• Identify how to promote better awareness of the bowel cancer screening to help increase uptake on the screening programme.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

The Leys Health Centre Dunnock Way, Oxford, Oxfordshire, OX4 7EX is a GP practice that provides healthcare to approximately 10,500 registered patients.

During our inspection we spoke with the GPs, registered manager, the practice manager, practice nurses, staff, patients and their relatives.

The practice provided a safe service that met patients’ needs. There were arrangements in place to ensure patients could either see or speak with a GP but not always at a time suitable for them.

The staff worked very well as a team and supported each other. Patients were treated in a safe and caring environment. The service was effective, well led and responsive to people’s needs. However, the practice did not keep up to date training records for staff.

The practice provided an open surgery, where patients could walk in without an appointment between 8.30am and 10am and be seen by a GP. However, it identified that this was no longer meeting the needs of the patients and had put plans in place to improve the emergency appointment system.

Letter from the Chief Inspector of General Practice

We carried out a desk based review (an inspection where we do not need to visit a practice in order to review the evidence we need) in November 2016 at The Leys Health Centre. This was following an inspection in February 2016 where we identified improvements were required in providing responsive services. We issued a requirement notice under Regulation 17 Good Governance of the the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. There were also areas we advised the practice should make improvement and offered the provider the chance to inform us what action they had taken as a result. We have rated the responsive domain as good. This report should be read in conjunction with the previous comprehensive inspection report.

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

• Improvements to accessibility of appointments had been made through staff recruitment.
• Patient engagement including a survey was formulating improvement plans for the appointment system.
• Communication with patients was used to inform them how the appointment system worked.
• Staff had been provided with training on the legal requirements related to consent to care and treatment.
• Information on bowel cancer screening had been purchased and displayed for patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice