Archived: NEMS Platform One Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at NEMS Platform One Practice on 30 June 2015. Overall the practice is rated as outstanding.

We found the practice was good for providing safe services and outstanding for providing caring, responsive and effective services and for being well led. It was also outstanding for providing services for the six population groups.

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

• The practice population was very diverse. It included a high transient population and numbers of patients who were vulnerable, homeless, seeking asylum, misused substances or had poor mental health.
• The staff team were highly responsive to meeting patients’ needs and engaging with hard to reach groups, to improve their welfare and reduce health inequalities.

• Feedback from patients was continually positive about the care and treatment they received and the way staff treat them. Staff involved and treated patients with compassion, kindness, dignity and respect.

• Patients were able to access care and treatment when they needed it, and could access appointments and services in a way, and at a time that suited them. The practice provided a transport service to patients who struggled to attend appointments.

• The practice used innovative and effective ways to improve outcomes for patients. High importance was placed on improving patients’ health by offering various screening checks and regular health reviews.

• The services were tailored to meet people’s individual needs and delivered in a way to ensure flexibility, choice and continuity of care. The staff team worked collaboratively with other services to meet patients’ needs, and support vulnerable individuals.

• The practice was safer than other similar practices as people were protected by comprehensive systems to help keep them safe. There was a pro-active approach to anticipating and managing risks, and a focus on openness and learning when things went wrong.

• The practice actively sought the views of patients and staff and implemented improvements to the way it delivered services in response to feedback.

• The practice had a large staff team, which continued to increase in size and skill mix to meet patients’ needs and the expansion of the service.

• The practice had a highly motivated and committed staff team who worked well together. Staff were actively supported to continually develop their knowledge and skills to ensure the delivery of high quality care.

• The practice was exceptionally well-led. The management and governance of the practice assured the delivery of high-quality person-centred care.
• The culture and leadership empowered staff to carry out lead roles and drive continuous improvements. High standards were promoted and owned by all staff.

We saw several areas of outstanding practice including:

• The practice provided a wide range of services to meet patients’ diverse needs. For example, 25% of patients had poor mental health. The practice had developed its own primary mental health services, which included a lead GP and two experienced nurses. One of which was a prescriber and the other was a psychotherapist, which enabled them to offer a broad range of treatments to patients.
• In addition, the two GP leads for substance misuse held weekly shared care clinics, which enabled patients to be treated at the practice. The clinic held at the branch surgery was extended to non-registered patients; seven out of 27 patients attending this were not registered with the practice.
• The practice had high numbers of patients who were asylum seekers. The practice was working with public health and the local charity for refugees and asylum seekers, to develop a multilingual booklet, which would enable families from overseas to understand the National Health Service.
• High importance was placed on educating patients to self-manage their conditions. For example, the practice had implemented a City wide initiative, which demonstrated the use of inhalers by video, and simple physiotherapy exercises for the benefit of patients with asthma and musculoskeletal conditions.

Importantly the provider should:

Develop the clinical audit programme to ensure that all audits are completed to a consistent standard to provide assurances that patients are receiving effective care and treatment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice