Archived: Ivybridge Medical Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Ivybridge Medical Practice on Wednesday 16 March 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• The practice had gone through organisational changes in the last eighteen months. There was now one partnership practice organisation delivering service out of four sites. Staff said this transition had been handled well and had improved resources. Patients told us they had been made aware of the changes but said they had not found the changes disruptive.

• 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.

• Medicines were manged well at the practice. The practice actively worked with the community pharmacy to develop a model where patients with less complex needs could access support through their high street pharmacy. Patients from the practice accessed support via the Pharmacy First scheme. The practice were working with the patient groups to increase this offer at more convenient locations with longer opening hours than the practice.

• Staff had access to a structured induction programme which was tailored to the role of each member of staff, including temporary staff. There was an encouraging culture of education and learning within the organisation which was monitored well.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• The practice offered specialist musculoskeletal and dermatology clinics by specialist GPs whom provided additional screening and treatment plans for an increased number of patients rather than onward referral to secondary care. Feedback of this service has been positive and patients have been seen within 4-6 weeks rather than 18 weeks and received services closer to their home. The practice had found that for 80% of patients seen, care and treatment was provided locally rather than referral into secondary care.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a GP, although a small number of patients said getting through on the telephone was sometimes a problem. Patients added that there was continuity of care, with urgent appointments being available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management.
• There was a ‘staff comms’ group who met with senior managers and partners to discuss staff issues and concerns. The group consisted of 12 self-volunteered members of staff and had performed staff surveys regarding management issues, workload and pay. Staff told us that this group had encouraged them to be involved and engaged in how the practice was run.
• The provider was aware of and complied with the requirements of the Duty of Candour.

• There was an active patient participation group (PPG) which met regularly and contained representatives from all population groups. The group had been involved in the survey questionnaire, had worked with other PPGs within the organisation to improve community involvement and had recently organised a lifestyle fayre for people in the community. The PPG had also organised information evenings on topics including stroke and dementia which had been attended by the GP.

The area where the provider should make improvements are:

• Continue with the discussions and investigation into why exception reporting figures for mental health and cancer indicators are higher than expected.

• Review the need to store controlled drugs at practice taking into consideration the location of the practice and proximity of nearest pharmacy and paramedic cover.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice