We decided to undertake an inspection of this service following our annual review of the information available to us. This inspection looked at the following key questions effective, caring, responsive and well led. We didn’t look at the key question safe as there were no concerns, therefore the rating of good in safe will carry forward from the last inspection
The practice was previously inspected on 11 May 2016. The inspection was a comprehensive inspection under the Health and Social Care Act 2008. At that inspection the practice was rated good overall.
At this inspection in June 2019 we based our judgement of the quality of care at this service is on a combination of:
- what we found when we inspected
- information from our ongoing monitoring of data about services and
- information from the provider, patients, the public and other organisations.
We have rated this practice as good overall with responsive rated as outstanding.
We rated this practice as outstanding for providing responsive services because:
- There was a strong person-centred culture.
- There were innovative approaches to providing education to patients and the wider community.
- People were truly respected and valued as individuals and empowered as partners in their care
- Services were tailored to meet the needs of individual patients. They were delivered in a flexible way that ensured choice and continuity of care.
- There were innovative approaches to providing integrated person-centred care.
- The practice had identified areas where there were gaps in provision locally and had taken steps to address them.
These outstanding areas in responsive benefitted the population groups for families, children and young people and people whose circumstances may make them vulnerable and so we rated these population groups as outstanding.
We also rated the practice as good for providing effective, caring and well led services because:
- The practice provided care in a way that kept patients safe and protected them from avoidable harm.
- Patients received effective care and treatment that met their needs.
- The culture of the practice and the way it was led and managed drove the delivery and improvement of high-quality, person-centred care.
We saw several areas of outstanding practice including:
- All male patients between the ages of 40 and 80 were invited to a Prostate Cancer awareness day held by the practice. The PPG assisted in organising the day by advertising in local supermarkets and in the surgery. The event was attended by a male prostate cancer nurse, GPs and a nurse so that patients could be tested on the day. 65 men attended and 12 were tested on the day. 1 patient hadn’t been to the surgery for a number of years and told the staff that he had attended because of the event.
- All patients over the age of 16 were contacted by the practice and asked if they had served in the military. As a result, 208 patients were now on the practice military veterans register. The practice then organised a Veterans in the Community event where information including a website and a newsletter was prepared and offered to all the veterans. Some patients had carried on meeting with some of the other veterans reducing the isolation that some of them felt. The practice manager is a military veteran and offers an informal chat with support for anyone that wants it. The practice had signed up to the RCGP as a veteran friendly practice.
- The practice had its own foodbank which was provided by the GPs and staff. Since the introduction of the foodbank, the practice told us that they had helped 10 families with each having up to three packages of food. At Christmas they had also included presents for families where they were needed.
- The practice with another local practice took it in turn to host regular coffee mornings which were run by the practice staff. Refreshments were provided and games such as bingo and dominoes available. Patients who were struggling with loneliness and isolation were invited and attended.
- Some of the GPs and staff volunteer their time and engage with the local Homeless Alliance Response Team (HART). The practice donated flu vaccines and some medical supplies to the service.
- The practice had secured funding to carry out a pilot in which patients between the ages of 14 and 40 with a BMI of over 27 were offered a fitness regime and dietary advice to promote weight loss. This included hiring fitness instructors and a chef to give ideas and tips of meals to cook and how to cook them. During the pilot 78 patients had used the service which had received excellent feedback. The practice was able to give us examples of the challenges and results of some of the patients as shown in the evidence table.
- The practice made a 40% reduction in the prescribing of Benzodiazepines between 2017/2018 and 2018/2019. CCG data presented to us showed a reduction from 250 prescriptions issued in 17/18 to 165 prescriptions issued in 18/19.
- The practice carried out a search every three months for patients prescribed a type of antibiotic. Since August 2017 the number of prescriptions issued was 343, this had been reduced to 28 in March 2019. This was due to better prescribing leading to fewer side effects and better care for patients.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care