Abbey Medical Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Abbey Medical Centre on 27 October 2016. The overall rating for this service is outstanding.

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

• There was a system to raise concerns and report significant events. Staff understood their responsibilities to raise concerns and to report significant events. These were discussed regularly at meetings and were a standing agenda item. Learning was shared with practice staff regularly and with other practices in the locality.
• Patients’ needs were assessed and care was provided to meet those needs in line with current guidance.
• Staff received regular training and skill updates to ensure they had the appropriate skills, knowledge and experience to deliver effective care and treatment.
• Risks to patients were assessed and well managed through practice meetings and discussions with the multi-disciplinary team. Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Information about safety alerts was reviewed and communicated to staff in a timely way.
• Patients told us GPs and nurses at the practice treated them 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 in the reception area and on the practice website.
• The practice had suitable facilities and was equipped to treat patients and meet their needs. This included easy access for patients who used wheelchairs.
• There was a clear leadership structure and staff told us they felt supported by the management team.
• The practice had an active Patient Participation Group (PPG) and proactively sought feedback from patients, which it acted on. Staff were committed and motivated to deliver high standards of care and there was evidence of team working throughout the practice.
• GPs used their specialist skills in areas such as minor surgery and dermoscopy (to assess all skin lesions) which resulted in the practice being low referrers to secondary care. Referral figures from 2013 to 2016 showed a reduction in dermatology referrals of 20%. The referral figures to secondary care for the same period showed an overall 40% reduction.
• Five nurses at the practice were trained to provide appropriate diabetes management clinics. They provided an annual total of 3280 appointments with 450 home visits to patients to ensure treatment was monitored.
• Age UK carried out assessments for housebound patients who were at risk of social isolation and loneliness either by telephone or through home visits. An administrator was employed by the practice to liaise with both patients and Age UK. The practice had made 116 over 75 assessments in the last 6 months and referred 35 of these patients to Age UK for further support.
• The practice had engaged with patients, the PPG and patient volunteers to assess available transport options to and from the practice and parking facilities. A travel plan was devised which also encouraged patients to walk, cycle or consider car sharing when accessing the practice, encouraging patients to increase their exercise and consider a healthier and greener way of living.
• Patients with a newly diagnosed long term condition were referred for educational meetings and clinics to help them manage their condition.
• The practice offered combined appointments to enable first baby checks, initial immunisations and postnatal assessments for mothers to be carried out in one visit.
• The practice had a comprehensive audit programme in place which demonstrated a quality monitoring and improvement process for all services they provided which included clinical and non-clinical areas.

We saw several areas of outstanding practice including:

• The practice had extended the building to provide four new consulting rooms, a large administration area and an enlarged and improved waiting room to cater for the future rise in the local population. The practice had managed the build and maintained service provision while ensuring the continued safety of patients and staff.
• The interior decoration for the building extension and the waiting room was decided after consultation with patients, staff and assistance from the Alzheimer’s Society. There were plans to refurbish the rest of the building by redecorating and re-flooring throughout to bring the entire building up to the same standards as the new extension.