Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Manor Park Medical Centre, 2 Lerwick Drive, Slough, SL1 3XU on 21 October 2015. Overall the practice is rated as good.
Specifically, we found the practice was good for providing safe, effective, responsive, caring and well led services.
Our key findings across all the areas we inspected were as follows:
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Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. The majority of information about safety was recorded. However, reviews and follow ups of significant events and incidents were not thorough enough and lessons learned were not always communicated widely enough to support improvement.
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Risks to patients were assessed and well managed.
- 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.
- Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
- Information about services and how to complain were available and easy to understand.
- Patients said they found it easy to make an appointment with a named GP, with urgent appointments available the same day.
- The practice had good facilities and was well equipped to treat patients and meet their needs.
- There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
- The provider was aware of and complied with the requirements of the Duty of Candour.
We saw two areas of outstanding practice:
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The practice had responded to the needs of ethnic minority patients with long term conditions by developing a voluntary self-funded ‘meri-sehat’ (my-health) project that recognised the needs of patients who were feeling depressed and socially isolated due to cultural difference and language barrier. The project was aimed at and data showed that outcomes for vulnerable patients with long term conditions had improved. For example, the practice had carried out a satisfaction survey. This demonstrated that patient outcomes were extremely positive and patients were feeling more motivated, alert, happy and included in society. We also noted the positive impact on prescribing rates because patients were self managing their long term conditions better due to improved lifestyles. For example, the practice had lowest prescribing and emergency admission rates compared to other practices in the local clinical commissioning group (CCG).
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One of the GPs had carried out an extensive research project on diabetes for three years. The practice had 90% South Asian patient population with high prevalence rates of diabetes. The practice was providing in-house diabetic management services to 1076 diabetic patients (10.4% of the patient list size). The practice had carried out repeat audits as part of a research project on 290 patients with diabetes. These audits showed diabetic patient outcomes were above average, for example, substantial reductions of blood sugar levels with lifestyle changes controlled by diet, a significant reduction in cholesterol, weight loss and a reduction in medicines prescriptions used to manage diabetes. We saw the practice was delivering the most cost effective diabetic services compared to other practices in the CCG.
In addition the provider should:
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Review the process for investigating and implementing change from incidents, significant events and complaints to ensure actions are completed. Improve the recording of discussions and actions during practice meetings.
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Ensure all staff have completed role specific mandatory infection control training and the practice should review training guidance according to infection control assurance framework.
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Ensure shared care plans for patients on the high risk of admission register are available to external organisations.
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Ensure an induction pack is available for locum GPs.
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Further review the waiting time it takes to get through to the surgery by phone.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice