In the last week or so, a further 79 inspection reports were published by the CQC. Of those, 59 practices were found to be good and five outstanding. This marks an upward trend in the percentage of practices receiving high scores and brings the total number of outstanding practices up to 149.

Continuing our popular look at what makes practices outstanding, here are a few pointers from the latest inspection reports:

Well-led

Balmoral Surgery in Kent received a glowing report, with inspectors finding them to be outstanding when it comes to responsiveness and leadership. On the leadership front, inspectors highlighted:

• The practice had a clear vision with 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.
• High standards were promoted and owned by all practice staff and staff worked together across all roles. Many staff had developed their roles within the practice for example, from an administration role to a clinical role or by taking a lead or championing role.
• Governance and performance management arrangements had been reviewed and took account of current models of best practice and the local population needs.
• The practice considered succession planning and acknowledged the ongoing difficulties in recruiting healthcare professionals. It supported trainee GPs and student nurses. It mentored allied healthcare professionals to become independent prescribers. There was an assistant practice manager who supported the practice manager whilst developing an understanding of the role.
• There was constructive engagement with staff and a high level of staff satisfaction. There was low staff turnover and a low level of staff absence due to sickness. The practice gathered feedback from patients and was supported by an active patient participation group which influenced practice development and patient care.

Success across the board

Bedlingtonshire Medical Group in Northumberland was rated outstanding in four of the five key areas.

Frankly, there are too many individual areas of success to cover (the full report can be found here) but inspectors highlighted the following areas:

• The practice had implemented a number of initiatives as part of their High Risk pathway, which was designed to manage patients at risk of unplanned hospital admissions. These included a review of prescribing which had reduced unnecessary repeat prescriptions by 16%, and the development of their own evidence-based care plans to allow patients with respiratory conditions to manage them at home. Since implementing these measures the practice had reduced unplanned hospital admissions for their patients from 239 in 2013/14 to 99 in 2015/16. Some of these initiatives had been adopted by the local clinical commissioning group (CCG) and extended to practices across the region.
• The practice manager had designed and implemented an evidence-based system for reporting and analysing significant events. This had created a culture which prioritised safety and learning in the practice, and resulted in an increase from 11 significant events reported in 2013 to 54 in 2015, driving a number of improvements at the practice. Where the practice did not achieve 100% of the Quality and Outcomes Framework points available for a particular domain, a significant event analysis was performed to learn what could be improved. All staff, administrative and clinical, were included in this process, and patients were invited to be involved to suggest ways to improve.
• A practice nurse with experience of minor illness care had been employed to implement a minor illness clinic at the practice. They created an evidence-based minor illness triage pathway developed for receptionists, and any patients who fit the criteria on the list could be given an appointment with the nurse instead of a GP. Minor illness appointments were blocked out for these patients, creating on average 25 additional GP appointments per day.

Glowing report

Another glowing report was received by Corbett Medical Practice in Worcestershire. Inspectors pointed out three key areas of particular note:

• A GP had been very involved with securing funding for and setting up the Droitwich Dementia Centre.
• The practice participated in a local Social Prescribing Pilot project, which provided additional support for patients with poor mental health.
• The practice had produced a ‘Booklet of Opportunity’ to promote the range of professional development available to GPs working at Corbett Medical Practice, in order to counteract the difficulty in recruiting GPs.

Once again, this practice’s full report is well worth reading.

Outstanding examples

Another two practices received outstanding ratings – Park Lane Surgery in Derbyshire and Drs Irwin, Goodwin and Fargnoli in Cambridgeshire – and were praised for the following:

• Hosting of a screening programme for Abdominal Aortic Aneurysm (AAA) which was attended by 302 people aged over 65. This led to aneurysms being detected in 5.5% of patients who attended which would otherwise have remained undetected.
• Implementation of a Melanoma Awareness event at the practice where screening was provided on the day and onward referrals made to treat potential or actual identified skin cancers for five patients who might otherwise have not visited their GP about their skin lesion.
• Drs Irwin, Goodwin and Fargnoli recognised the lack of public transport for patients to get to the practice, and organised a patient-led transport scheme. This service was promoted to new patients in the practice newsletter and on the patient participation group (PPG) noticeboard.
• The same practice was innovative and proactive in setting up new services in the area. For instance, the practice promoted exercise programmes to patients identified as at risk of cardiovascular disease at NHS health checks. The senior partner at the practice had organised a weekly parkrun to take place nearby after recognising the need for local, free-of-cost exercise groups in the area. We received positive feedback from patients about these services.

The fact that our blogs about success stories are getting longer is testament to the fact that practices are scoring more highly than ever in inspections. Keep up the good work and keep checking out the CQC inspection reports at www.cqc.org.uk.

Read more about the CQC inspections in the Practice Index Forum. We also welcome your comments regarding the latest results, either in the comment box below or on the forum.

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