Archived: Cobtree Medical Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cobtree Medical Practice on 1 June 2017. Overall the practice is rated as outstanding.

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

• There was an open culture in which all safety concerns raised by staff and patients were highly valued as integral to learning and improvement. The level and quality of incident reporting showed included assessments of harm and near misses, which ensures a comprehensive picture of safety. All opportunities for learning from internal and external incidents were maximised. The practice shared learning from safety incidents with other nearby practices on a regular basis.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice.
• 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. For example through having a child themed a “fun day” which had doubled the child take up of influenza vaccinations.
• 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 (PPG). For example the practice had held a public meeting about a proposed merger of practices with the support of the PPG.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Feedback from patients about their care was positive and was consistently significantly better than local and national feedback. There was continuity of care, in the most recent GP national survey, 95% patients saw their GP of choice compared to national average of 59%.
• The practice actively reviewed complaints and how they are managed and responded to, and made improvements as a result.
• 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. All staff were involved in developing the vision and values for proposed merged practice.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.

We saw several areas of outstanding practice including:

• GPs gave a designated mobile contact telephone number to patients who were dying at home and were contactable in the event of a crisis out of surgery hours and at weekends. The same facility was available to the clinical staff the local nursing home for advice on avoiding admission to hospital or end of life care.
• Data showed that patients rated the practice significantly higher, for the caring and the responsive aspects of its services, than all the local and national averages.
• The practice had proactively recruited patients to the patient participation group so that it was truly representative of the practice demographic.
• The practice had mounted an initiative to increase the take up of influenza vaccinations for children aged two, three and four which had had a regional impact.
• The practice had identified patients likely to be at risk of acute kidney injury,had sent them informative leaflets and monitored their welfare.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice