Archived: Dr Ian Kelham Also known as Porlock Medical Centre

Letter from the Chief Inspector of General Practice

OUTSTANDING

We carried out an announced comprehensive inspection at Dr Ian Kelham (Porlock Medical Centre) on May 7 2015. Overall the practice is rated as outstanding.

Specifically, we found the practice to be outstanding for providing responsive, caring and effective services. It was also outstanding for providing services for older people and people with long term conditions. It was good for providing safe and well led services. It was also good for providing services to the working aged population including those recently retired and students, families, children and young people, people with poor mental health and people whose circumstances make them vulnerable.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example a project with Age UK; tele-dermatology with hospital consultants and practice visits by the endocrinologist.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet people’s needs.

• The practice 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 practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand
• The practice had a clear vision which had quality and safety as its top priority. A business plan was in place, was monitored and regularly reviewed and discussed with all staff. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

We saw several areas of outstanding practice including:

We saw that the practice was responsive to the needs of the local population. For example, the practice had increased the flexibility of access to appointments and could demonstrate the impact of this by reduced use of the Out Of Hours and secondary acute service and very positive patient survey results. The practice had a very good skill mix which included a home support nurse to visit the isolated; those with a high risk of hospital admission and those with a high need for medical care. The practice provided comprehensive screening and regular reviews for patients at risk of developing long term conditions. As well as additional planned medicine and health reviews of patients with long term conditions. The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice; which comprised of a project with Age UK to provide support for isolated patients and tele-consultations and practice visits to patients by specialist hospital consultants.

We saw that the practice cared for the population through provision of additional services to enable end of life patients to remain at home. This included funding a night sitter nursing service for the local population; direct contact with a practice GP out of hours and providing additional clinical interventions normally undertaken in a hospital. The practice had reached out to the local community in order to prevent illness by writing a healthy lifestyle article in the local magazine; providing an annual flu vaccination clinic which included invitation to local organisations to attend and an annual men’s health evening to promote better health. All these were not limited to the practice population. The practice had undertaken a project with Age UK to provide support to isolated patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice