The Leeds Road Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Leeds Road Practice on 19 May 2016. Overall the practice is rated as good.

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

• 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 mostly assessed and managed.
• Systems were in place to ensure that all clinicians were up to date with both National Institute for Health and Care Excellence (NICE) guidelines and other locally agreed guidelines. The practice used these guidelines to positively influence and improve practice and outcomes for patients.
• Data showed that the practice was performing highly when compared to practices nationally and in the Clinical Commissioning Group (CCG). The practice had achieved 100% of the total number of points available for the Quality and Outcomes Framework (QOF). This was above the CCG average of 98% and the national average of 95%. The practice had an exception reporting rate comparable to national averages with most being below the national averages.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they mostly found it easy to make an appointment with urgent appointments available the same day. The practice had reviewed their appointment system in response to feedback.
• The practice mostly had good facilities and was well equipped to treat patients and meet their needs. The practice was aware of the challenges the premises posed and was working with the other partners to address these issues in the longer term.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

There was a focus on continuous learning and improvement at all levels within the practice.

We saw two areas of outstanding practice:

• The practice regularly worked with other health care professionals in the case management of vulnerable patients. We were provided with many examples of significant multi-agency working to try and support and improve the outcomes for patients. For example the practice had worked with multiple agencies in respect of one patient and now had an agreed plan in place that was benefitting the patient and the agencies and services the patient was involved with.As a result of the agreed care plan the patient was receiving regular telephone calls from the practice and reducing the time spent contacting and visiting other services such as accident and emergency.
• The practice proactively sought patients’ feedback and engaged patients in the delivery of the service. They had a very engaged patient participation group (PPG). The patient group comprised of 300 virtual members. Eight of the virtual members formed the committee and met with the managing partner on a quarterly basis. The committee was made up of volunteers from the virtual PPG and managed by the Chairman. The PPG met regularly and one Friday of every month a member of the committee attended the practice for three hours meeting patients in the practice to discuss any points that patients may have. This was then then fed back to the practice. The practice also gathered feedback from patients using new technology. For example the practice had social media pages where patients could leave feedback. The practice reviewed and updated these sites regularly.

The area where the provider must make improvement is:

• The practice must take immediate action to ensure recruitment arrangements are in line with Schedule 3 of the Health and Social Care Act 2008 to ensure necessary employment checks are in place for all staff. Specifically, this includes completing Disclosure and Barring Service (DBS) checks for those staff that need them.

The areas where the provider should make improvement are:

• The practice should ensure it has systems in place to undertake detailed analysis of the significant events over a period of time to enable themes to be identified and appropriate action taken.

• The practice should ensure they assess and manage the outstanding issues identified as high risk in the recent fire risk assessment.
• The practice should ensure they have a specific risk assessment in place in respect of alternative medical scheme (AMS) patients when visiting the practice. The AMS scheme is for patients deemed to pose risk to practices and have been removed from other practice lists.
• The practice should risk assess the current arrangements in place for the delivery of medicines in the community.
• All clinical staff should have emergency response training.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice