Porter Brook Medical Centre

We carried out an inspection of this service following our annual review of the information available to us including information provided by the practice. Our review indicated there may have been a significant change to the quality of care provided since the last inspection.

This inspection focused on the following key questions:

• Is the service effective?
• Is the service responsive?
• Is the service well -led?

Because of the assurance received from our review of information we carried forward the ratings for the following key questions:

• Is the service safe?
• Is the service caring?

We based our judgement of the quality of care at this service  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 outstanding overall.

We rated the practice as outstanding for providing responsive services because:

• The provider had developed services in response to their patient population, specifically their student population and people experiencing poor mental health.
• There was a proactive approach to understanding the needs of different groups of people and to deliver care in a way that met these needs.
• The practice had identified areas where there were gaps in provision locally and had taken steps to address them.

These outstanding areas benefited the population groups working age people (including those recently retired and students) and patients experiencing poor mental health so we have rated these population groups as outstanding and the other population groups as good.

We rated the practice as outstanding for providing well-led services because:

• The vision, strategy and culture of the practice and the way it was led and managed drove the delivery and improvement of high-quality, person-centred care. Practice leaders were innovative and openly shared with others.
• Feedback from patients who used the service, those close to them and external stakeholders was continually positive about the way the service responded to the needs of patients.

We also rated the practice as good for providing effective services because:

• Patients received effective care and treatment that met their needs.

We saw several areas of outstanding practice including:

• TThe practice had implemented a registration system to ensure patients with long-term conditions were seen immediately on the day of registration to ensure continuity of care.
• All new students registering at the practice completed a mental health assessment to identify and offer immediate GP support. Staff worked with other stakeholders to ensure the safety of patients by screening international students prior to commencing at the university.
• The practice had improved processes to ensure students were seen in a timely manner and had adjusted services to meet their specific needs.
• The provider had arranged for a Consultant Psychiatrist to hold clinics at the practice for the benefit of their patients to prevent waits to secondary care.

• The provider had identified students with diabetes who were not being treated within secondary care following transition from home and childrens’ services. They had arranged for a Consultant in diabetes to attend the practice to see these patients.

• Clinical staff were trained in supporting patients with eating disorders and offered a regular clinic to those patients who required support and guidance.

The area where the provider should make improvements are:

• Review the coding used in the patient notes to record the review appointment for patients seen following a new cancer diagnosis.
• Take action to further review areas of high exception reporting for patients with long term conditions.

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