Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Whitefield Medical Services on 4 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.
• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.
• There were systems in place to assess and monitor risks to patients.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• The practice used innovative and proactive methods to respond to the local population improve patient outcomes, working with other local and national NHS providers to share best practice. For example, the practice had invited patients in for bowel screening clinics in response to low take-up.
• The practice also ran a musculoskeletal clinic. This supported patients with pain management and a range of conditions which would otherwise have been referred to secondary care.
• Feedback from patients about their care was positive.
• 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.
• There was a clear leadership structure and staff felt supported by management.
• The practice had a clear vision which put patient safety as the top priority.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Access to appointments was well managed.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We found one area of outstanding practice:

The practice had reviewed a range of health activities and communication with patients to meet the needs of a diverse patient population group. The impact of this could be seen for childhood immunisation and cancer screening uptake. Specifically the practice had:

• Held bowel cancer screening awareness clinics within the practice to improve screening amongst the British Pakistani community. 21 additional patients had completed screening following this intervention. Of 106 patients eligible only 42% had completed screening according to National Cancer Information Network data published in March 2015, which was lower than the CCG and national averages of 58%. The practice had supported another 21 to complete screening, which should lead to an increase of 18% and bring the practice in line with averages when current data is published.

• Raised awareness with parents of the importance of childhood immunisations and the prevalence and risks of genetic diseases.

• Raised awareness within the British Pakistani community of the importance of cervical screening for women, this included overcoming cultural prejudice to achieve a screening rate of 89% which was higher than the national average of 82%.

The areas where the provider should make improvement are:

• Improve the system for authorising patient group directions and patient specific directions locally to ensure these are appropriately authorised.

• Review organisational health and safety arrangements and conduct risk assessments in line with the requirements of the Health and Safety at Work Act 1974.

• Maintain a local log of privacy curtain replacements and liaise with the building manager to ensure these are replaced in accordance with guidance.

• Record actions taken following Medicines and Healthcare products Regulatory Agency (MHRA) and other nationally issued safety information and ensure these are reviewed appropriately.

• Review local induction arrangements to include hand hygiene training and ensure that staff are aware of mandatory elements such as safeguarding if on-line resources are not available.
• Provide complaints information in languages or formats to meet the needs of the population groups

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice