Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at White Horse Medical Practice on 24 February 2016. Overall the practice is rated as good.

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

• The practice had a vision which had quality and safety as its top priority. A business plan was in place, was monitored and regularly reviewed and discussed with all staff. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

• The practice had an effective governance system in place, was well organised and actively sought to learn from performance data, incidents and feedback.

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.

• Risks to patients were assessed and well managed, this included premises maintenance, equipment checks and emergency procedures. All staff checks required were undertaken however not all recruitment and background check correspondence were accessible on the day of inspection.

• Feedback from patients and stakeholders about their care was consistently and strongly positive.

• Historically outcomes for patients who use services were consistently very good. Nationally reported Quality and Outcomes Framework (QOF) data, for 2012/13 and 2013/14, showed the practice had performed excellently in obtaining almost all of the total points available to them for providing recommended care and treatment to patients. We saw evidence of data irregularities for the 2014/15 period and saw the practice was proactive in seeking a resolution to these irregularities.

• 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.
• We found there was good staff morale in the practice, with high levels of team spirit and motivation. There was a strong learning culture evident in the practice. This came across clearly through discussions with staff members and in the approach to adopting and championing new initiatives.
• It was evident the practice had gone through a period of transition including a merge of practices. There was a clear leadership structure and staff felt supported by management.

We saw several areas of outstanding practice including:

• The practice was consistent in supporting patients to live healthier lives through a targeted and proactive approach to health promotion. For example, the practice invited all non-UK born patients to be screened and tested for hepatitis B and C (a virus that can cause inflammation of the liver). Of the patients screened so far, we saw evidence of patients who have now had a positive diagnosis for hepatitis and have since received care and treatment to manage this condition which was previously undiagnosed.

• White Horse Medical Practice actively supported breast feeding mothers. For example, there was a weekly breast feeding clinic at the practice every Monday called ‘The Baby Bar’, clear signage welcoming breast feeding mothers and a private space was available for breast feeding mothers.

• White Horse Medical Practice is research active, supporting a number (approximately 25 clinical trials) of National Institute of Clinical Research (NIHR) portfolio studies. The practice working with their patient participation group (PPG), community groups and other local organisations, ran a comprehensive survey on maternity service needs across Oxfordshire. In February 2016, the practice was awarded first place in the Research Engagement Award (NIHR Clinical Research Network award in partnership with the National Association for Patient Participation (N.A.P.P.) which celebrated the outstanding leadership and dedication by the PPG in health research in primary care.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

We reviewed the information available to us about White Horse Medical Practice on 8 June 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.