Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Windmill Practice on 11 May 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 and near misses, and we saw evidence that learning was applied.

• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, education courses for patients with long term conditions such as diabetes and working with the local diabetes specialist nurse to improve the wellbeing of patients.

• There was easy access to appointments for patients whose circumstances made them vulnerable, for example homeless patients, asylum seekers and patients from the traveller community. They were assured of an appointment on the day when they presented to the practice without a booked appointment.

• Feedback from patients about their care was consistently positive. Data from the GP survey was consistently high.

• The practice planned and co-ordinated patient care with the wider multi-disciplinary team to plan and deliver effective and responsive care to keep vulnerable patients safe.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group.
• The practice actively reviewed complaints to see if there were any recurrent themes, and identified issues where learning could be applied to improve patient experiences in the future.
• 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.

• The practice had strong and visible clinical and managerial leadership and governance arrangements, and staff told us that they were well-supported and felt valued by the partners and the practice manager.

We saw areas of outstanding practice including:

• The practice was committed to working with people whose circumstances might make them vulnerable. For example, the practice had a long history of working with homeless patients across Nottingham and provided substance misuse clinics to their own registered patients and those registered as temporary residents. In addition to removing barriers for these patients to access services at the practice, they undertook outreach clinics in local hostels on a weekly basis.

• A number of GPs used their expertise to provide education to colleagues locally and nationally in areas such as substance misuse, domestic violence, child safeguarding and health management of asylum seekers.

• The practice demonstrated continuous improvement and innovation in leading on a number of pilot schemes within their Clinical Commissioning Group (CCG) which are now available as commissioned services, such as prostate cancer screening service for men of African Caribbean ethnic background, a community epilepsy specialist nurse and an urgent referral service to Welfare Rights.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice