Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Trinity Medical Centre on 12 January 2017. Overall the practice is rated as good.

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.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

• The practice actively reviewed complaints and how they were managed and responded to, and made improvements as a result.
• 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. For example, obtaining a cold water dispenser for the waiting area and installing a ‘please wait’ barrier in front of the reception area to increase confidentiality.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• Patients said they found it easy to make an appointment with a named GP and urgent appointments were 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 acted upon feedback from staff and patients.
• The provider was aware of and complied with the requirements of the duty of candour.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.

We saw areas of outstanding practice:

• The practice had introduce an initiative where by the practice nurse in partnership with the lead GP carried out virtual clinics with professionals from secondary care to review and provide appropriate treatments for patient with complex, unstable long term conditions. The clinics take place without the patient being present but patients were informed of these meetings. The specialist or consultant, GP and nurse met to discuss difficult to manage patients, for example those with diabetes.Prior to the meeting recent blood tests and reviews had been completed. Following the clinic the patients were contacted with an explanation of what had been discussed along with new advice, new prescriptions or changes in medication. As a result of these GPs were able to improve the management of patients and treat them closer to home. his saved costs and time to the patients as well as to the consultant and their team had hospital appointments been carried out.

• Both practice nurses had completed additional fire training so they were able to identify fire risks when they visited patients in their own homes. An example of how this impacted on patients was they gave fire safety advice and were able toassist and sign post patients to the community fire advice team

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice