We carried out an announced comprehensive at Townsend House Medical Centre on Friday 15 March 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as Good overall. (Previous rating September 2015 – Good)

At this inspection we found:

• Feedback from patients about the staff, care and treatment was positive. National patient survey results regarding staff, care, treatment and the service were consistently higher than local and national averages.
• Patients appreciated the appointment system and said it was easy to use. Patients reported that they were able to access care when they needed it.
• There was a stable leadership team. Leaders communicated well with each other and with the team. They were knowledgeable about issues and priorities relating to the quality and future of services.
• The leadership team were aware of and involved in the future of General Practice within the locality.
• The practice worked effectively with other practices in the locality.
• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice recognised where systems and processes had worked well and improved their processes where appropriate.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• There was a strong focus on continuous learning and improvement at all levels of the organisation. Staff said the practice was a good place to work and added that the leadership team were supportive and encouraged career development and learning to help improve patient safety.
• One of the GPs participated in a project to help improve social mobility. This involved helping and supporting students from deprived areas gain experience in health settings where they otherwise would not be able to access this.

We found areas of outstanding practice:

The practice took a leadership role in the local health and social care community to identify and proactively address challenges and meet the needs of the practice population. The leadership team were founding members of a federation of 13 GP practices and had led on many initiatives and projects to share resources, create resilience and improve quality in general practice. For example, the practice manager had developed and delivered a number of clinical IT processes, protocols, training programmes and mentoring schemes across the federation. The practice had also led on a data sharing system to enable all practices to access clinical data (with consent) to support the improved access extended hours programme.

The areas where the provider should make improvements are:

• Continue to review, monitor and address Quality Outcome Framework (QOF) exception reporting rates for respiratory diseases.
• Continue to review and identify carers at the practice.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice