Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Westcourt Medical Centre on 14 April 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. 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. It had worked in partnership with the county council to deliver a pre-diabetes well-being programme for patients identified as being at risk. Patient outcomes had improved as a result.
• Risks to patients were assessed and well managed.
• 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 worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. It had worked closely with local providers and voluntary organisations to improve the diagnosis and care of patients with dementia.
• 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. The practice actively reviewed complaints and how they are managed and responded to, and made improvements as a result.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw an area of outstanding practice:

• The practice actively supported patients to lead healthier lives. It worked in partnership with the county council to deliver a pre-diabetes well-being programme for patients identified as being at risk of type two diabetes. The programme focused on lifestyle behaviour change and provided support and guidance to patients on how they could slow down or eliminate the risk of developing the condition. The practice was able to demonstrate high uptake amongst its patients with each session being fully booked. It was also able to demonstrate high levels of patient satisfaction and some improvement in the pre-diabetes indicators for some patients who had attended the sessions.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection April 2016 – Outstanding)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced inspection on 11 May 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear, embedded systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes. Relevant learning was routinely shared with external stakeholders.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. There was a strong emphasis on making sure that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patient satisfaction was consistently high.
• Patients found the appointment system easy to use and reported that they could access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw one area of outstanding practice:

• The practice was pro-active in using a number of methods to seek patient feedback and engage with the public. This included the use of surveys tailored to seek feedback on specific areas of interest or concern. There was clear evidence that improvements were made to services as a result. For example, the practice undertook a survey to try and capture responses from existing patients and the 700 patients who had transferred to them from the recently closed neighbouring practice, plus new residents in the area from a new housing development. Improvements implemented included the promotion of the automated booking system, improving the efficiency of call handling and a review of the appointment system. It had also undertaken a survey to gauge awareness amongst patients of changes to the local health economy. The results helped facilitate joint working with other local practices on collective statements about the progress of any locality projects and ensuring waiting room screens and websites were updated as and when necessary. The practice optimised the functionality the friends and family test for use on smartphones and had increased response rates because of this. Improvements in response to feedback included an easier way to contact the receptionist when attending extended access appointments, with the fitting of a doorbell. The practice had also made use of the patients comment box and implemented several suggested improvements which included the ability to call for more reception staff at the front desk during busy periods.

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