Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Whitehaven Medical Centre on 17 November 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 the practice had a system for reporting and recording significant events, and learning from them.

• Risks to patients and staff were assessed and well managed. This included the development of systems and processes to support non-clinical staff to undertake delegated clinical tasks, and audits were being undertaken to ensure these were being carried out safely.

• Effective governance arrangements were in place.

• All staff were actively engaged in monitoring and improving quality and patient outcomes.

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

• The practice worked with other organisations when planning how services were provided, to ensure patients’ needs were met.

• Patients said they were treated with dignity and respect and that they were involved in decisions about their treatment.

• Information about services and how to complain was available and easy to understand.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• Staff were very committed to supporting patients to live healthier lives through a targeted and proactive approach to health promotion.

• A culture had been created which encouraged and sustained learning and improvement at all levels. Staff felt supported and respected, but it was evident that the new team was still undergoing a period of adjustment, following the recent merger.

• The provider had a clear vision and strategy for the development of the practice and were committed to providing their patients with good quality, safe care.

We saw some areas of outstanding practice:

• The lead GP provider had introduced a system for audio-recording and transcribing patient consultations. This system enabled him to focus on what the patient was saying, rather than on recording what was being said, and he was also able to see more patients during each clinical session. A further benefit of the system was that the clinical records were of a very high quality.

• Data from the NHS National GP Patient Survey of the practice, published in July 2016, showed patient satisfaction with access to appointments, was very good. For example: 100% of patients said the last appointment they got was convenient, compared to the local Clinical Commissioning Group (CCG) average of 94% and the national average of 92%; 96% of patients said they were able to get an appointment to see or speak to someone the last time they tried, compared with the local CCG average of 87% and the national average of 85%; 99% of patients found it easy to get through to the surgery by telephone, compared with the local CCG average of 80% and the national average of 73%.

However, there were also areas where the provider should make improvements. The provider should:

• Carry out more two-cycle clinical audits, to help demonstrate improvements in patient outcomes.

• Prepare a practice development plan which clearly sets out how the provider intends to enact their vision and strategy.

• Review the systems and protocols for preparing referral letters and dealing with incoming patient letters and blood results, to make sure that potential risks are assessed and minimised.

• Review the standard letter issued in response to complaints received to include details of the Parliamentary and Health Service Ombudsman.

• Consider providing a loop system for the use of patients who have a hearing impairment and, making the reception desk more accessible to patients who require the use of a wheelchair.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice