In the past week, the CQC has published a further 81 reports on the quality of care provided by GP practices that have been inspected. Another two practices were found to be outstanding, 61 practices were rated good, nine require improvement and, worryingly, five received inadequate ratings.

Outstanding performance

Leading the way with an outstanding rating was the Keyworth Medical Practice in Nottinghamshire, which received outstanding scores across three areas – for being caring responsive and well-led. The Springhead Medical Centre in Hull was also rated as outstanding in the areas of responsiveness and being well-led.

While the detailed, glowing reports on these two practices are available from the CQC website, here’s a summary of some of the key findings that the inspectors really liked:

Well-led

• A clear vision was in place 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.
• Governance and performance management arrangements had been proactively reviewed and took account of current models of best practice. For example, the PPG conducted their own internal audits of the practice environment and buildings. Where issues were raised actions were taken by the practice in a timely manner.
• Succession planning was in place.
• The practice gathered feedback from patients using new technology. It had a very active patient participation group which influenced practice development. For example, the PPG were actively and directly engaged in the contract and procurement process of a new building to site the practice. They were also actively involved with the contracted architect in the design; build and layout of the new building.
• Constructive engagement with staff had been initiated following changes in the management structure and this had contributed to improved staff satisfaction and development opportunities.
• It was demonstrated to inspectors that a strong focus on continuous learning and improvement at all levels was in place. This included empowering the patient participation group and staff to drive improvements within the practice.

Responsive

• The practices worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. The inspectors particularly liked that one of the practices provided support for a local charity that provided care for terminally ill children and they also worked with other organisations such as the NHS Citizens Assembly.
• One of the practices implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group (PPG). The PPG were positively active and engaged in the practice processes and assisted them in developing on-going changes to their friends and family test (FFT) programme. The FFT was closely monitored by the PPG and they changed questions regularly to meet different patients’ needs and they were recently nominated for an FFT award due to their pro-active involvement in the process.
• Inspectors were impressed by the fact that patients could access appointments and services in a way and at a time that suited them. For example 6.50am appointments were available for patients with working commitments.
• Information about how to complain was available and easy to understand, and the practices responded quickly when issues were raised. Information gleaned from complaints was shared with staff and other stakeholders.
• The inspectors liked the innovative and proactive methods implemented to improve patient outcomes, and the fact work was being done with other local providers to share best practice. For example, the practice had taken a lead in the design, development and implementation of community services specific to dermatology, gynaecology and home chemotherapy services. This enabled more patients to be treated locally by GPs and reduced the burden on hospital services.
• One practice provided good access to clinical appointments and this was confirmed by patient feedback and the national GP survey results. For example, 93% of respondents were able to get an appointment to see or speak to someone the first time they tried compared to the local average of 92% and national average of 85%.

Caring

• Staff were motivated and inspired to offer kind and compassionate care and worked to overcome obstacles to achieving this. There were many positive examples to demonstrate how patients’ choices and preferences were valued and acted on. Specifically the delivery of end of life care, care for older people living in care homes and those at risk of hospital admission.
• Feedback from patients about their care and treatment was consistently and strongly positive. This was also aligned with feedback received from a care home provider.
• The practice had empowered the patient participation group (PPG) to facilitate a bereavement self-help group which aimed to support the emotional needs of patients who were experiencing grief and loss. This service was accessible to people living within the local community and also addressed social isolation amongst its patient population. This was an outstanding feature which showed a commitment to being compassionate in the care for vulnerable people.
• The practice was engaged in the local health care of older people “in- reach” pilot, to facilitate appropriate and timely hospital discharges. The senior GP partner worked alongside four local GPs, a community matron, hospital consultants and staff working in the older people’s wards at Nottingham University Hospital. Benefits to older people included a coordinated and holistic approach to the management of their care and reduced lengths of inpatient stay.
• The practice provided a GP service to residents living in two care homes as part of an enhanced support service which aimed to improve the quality of care for older people by reducing unplanned admissions, emergency department attendances and risk of falls for example. Data reviewed reflected these aims were being achieved.

This is a very brief summary of the findings from two outstanding practices – the reports from these practices are well worth reading as they’re packed full of ideas that the inspectors loved.

What do you really like about the work of these practices? Are there any ideas that you will be copying? Let us know by commenting below or in the Practice Index Forum here.

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