Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Whitstable Medical Practice on 21 January 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. All 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. There was a very wide range of services, clinical and non-clinical. The practice was a Multi-speciality Community Provider with an ethos to bring services to the patient rather sending patients to the service.

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

• 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. The practice was part of a Vanguard site combining with other providers to deliver services across a substantial area of East Kent.

• 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 walk-in surgeries and changes to the telephone response times and methods of calling patients by telephone
• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.

We saw several areas of outstanding practice including:

• The practice had been effective in reducing the number of unplanned admissions to hospital for patients over 74 years. There was evidence to support that this was linked to the practice’s initiative to a provide paramedic practitioner home visit service across the area.

• The practice had a Patient Safety and Quality Manager who was responsible for ensuring that there was a thorough analysis of the significant events.

• The practice sponsored and supported a dementia café at one of their practice sites and was developing a similar café at a second site. Here people, patients and carers, with problems related to dementia, had their emotional and social needs met as well as addressing health issues.

• The practice was trialling social prescribing with local volunteer organisations as a means of directing vulnerable patients to non-clinical services that support social, emotional or practical needs.

• The practice had played a leading role in the formation and growth of the Encompass vanguard site across a substantial region of East Kent, enhancing the range and increasing the ease of access to services. This was consistent with the practice’s objective was to place the patients at the heart of the services, rather than the patients being sent round the health care system to access the services.

• Patients with complex or multiple needs were managed through integrated patient centred services, and were able to access services which would otherwise be up to an hour and a half away.

• It had a scheme for nursing and residential homes where an individual GP took responsibility. There were regular multi-disciplinary team meetings, which included a consultant geriatrician, relatives were routinely invited.

• The practice staff had undergone a number of innovative training events designed to increase staff interpersonal skills. There had been a role play workshop using actors to help improve GPs communication with patients. This was intended to reduce complaints and complaints had been reduced. The practice was involved in training at many levels and showed that as a practice they were as keen to learn from trainees as they were to teach them.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice