Archived: Chiltern Hills Practice Also known as IntraHealth Limited

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Chiltern Hills Practice on 13 September 2016. Overall the practice is rated as good.

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

• The practice had a clear vision and had recognised the particular needs of patients in the community it served.

• The practice team had worked to create an open and transparent approach to safety. A clear reporting system was in place for recording significant events and dealing with updates and alerts.

• Risks to patients were identified, assessed and appropriately managed. For example, the practice implemented appropriate recruitment checks for new staff, and followed up-to-date medicines management protocols. However, the practice did not have a current legionella risk assessment in place.

• We saw that the staff assessed patients’ needs and delivered care in line with current evidence based guidance. Performance was monitored using statistical analysis of national and local data and patient surveys; however, we found that the practice had not completed any clinical audits in the last 12 months.

• Staff were supported to access development learning and routine training was provided to ensure they had the skills, knowledge and experience to deliver effective care and treatment.

• Data from the Quality and Outcomes Framework (QOF) showed the practice had performed well, obtaining 97% of the total points available to them, for providing recommended care and treatment to their patients.

• The practice participated in the national awareness promotion week for carers and had raised the number of carers registered to almost four percent of the patient list.

• Feedback from patients was consistently positive. Patients we spoke with told us they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Comments from patients on the 33 completed CQC comment cards confirmed these views.

• Results from the GP Patient Survey published in July 2016 showed the practice was performing higher than local and national performance averages in some areas.

• Information about services and how to complain or provide feedback was available in the waiting area and published on the practice website. The practice had a thorough process dealing with patient feedback. Outcomes from complaints were shared and learning opportunities identified as appropriate.

• Appointments were readily available.Urgent appointments were available the same day, although not always with the patients named or usual GP.

• The practice had access to good facilities and equipment in order to treat patients and meet their needs.

• There was a clear leadership structure and we noted there was a positive outlook among the staff, with good levels of moral in the practice. Staff said they felt supported by management.

• The provider was aware of and complied with the requirements of the duty of candour.

The area where the provider must make improvement is as follows:

• Ensure completion of a legionella risk assessment and implement any recommendations made.

The areas where the provider should make improvements are as follows:

• Reconsider arrangements to review quality assurance at the practice, for example targeted clinical audit.

• Continue to check the newly implemented system to log and monitor prescription stationery.

• Continue to encourage patient attendance for cancer screening including for breast and bowel cancer.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice