Archived: Ocean Health

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Ocean Health on Tuesday 20 December 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 an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with 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. Feedback from the NHS friends and family tests was also positive.

• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns. Staff had access to guidance to whistleblowing policies and contact details within staff areas.

• Patients said they found it difficult to get through on the telephone to make an appointment. As a result the practice were in the process of introducing additional telephone lines and call handlers.
• Patients said they were able to speak with a GP or emergency practitioner on the same day but sometimes had to wait to see a GP of their choice if they wanted continuity of care.
• The practice had good facilities and was well equipped to treat patients and meet their needs.

• Text reminders were used to remind patients of their appointment. Patients could use text messages to cancel appointments in an attempt to reduce any ‘did not attend‘(DNA) appointments and in the process making more appointments available to other patients.

• 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.

• The practice had started to introduce systems to identify military veterans and to ensure their priority access to secondary care in line with the national Armed Forces Covenant 2014.

• The practice merger had identified gaps in data collection and had resulted in the introduction of computer software and a consistent approach to identifying conditions which aimed to improve the quality outcome framework (QOF) results.

We saw one area of outstanding practice:

The practice had responded to the needs of ill children and offered a walk in service for children under the age of five years. Parents and guardians could bring their child without appointment to twice daily children’s clinics. The service had received positive feedback from patients. Data from the practice showed that the service had seen an average of between 12 and 18 children per day with an increasing trend of attendances. Data showed there had been a reduction of patient numbers in this age group attending the emergency department (ED) during the day. For example ED day time admissions for practice children between 2013/14 was 40. This figure reduced to 35 in 2014/15 after the service had started. This showed a reduction of 12.5%.

The areas where the provider should/must make improvement are:

• Consider managing complaints in the same manner as significant events, as appropriate, to ensure learning is shared across the whole team.

• Introduce a system to ensure all clinical equipment which moves around the practice is included on the calibration checking programme.

• Inform patients of the action being taken as a result of their feedback.

• Ensure a system is in place for checking GP bags for expiry dates of medicines and equipment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice