Background to this inspection
Updated
6 December 2018
This report relates to the regulatory activities being carried out at The Falmouth Health Centre Practice which is situated in Falmouth, Cornwall. The practice is comprised of a single site. The address of the site is The Health Centre, Trevaylor Road, Falmouth, Cornwall TR11 2LH. We visited this site during our inspection. The practice has a website which is located at www.faldoc.co.uk.
The deprivation decile rating for this area is four (with one being the most deprived and 10 being the least deprived). The area had higher than average social and economic deprivation compared to the national average. The practice provides a primary medical service to approximately 9000 patients of a diverse age group. The 2011 census data showed that majority of the local population identified themselves as being White British.
There is a team of six GP partners, three female and three male; the partners supported a GP registrar. The whole-time equivalent is 4.75. The GP team were supported by a practice manager, patient services manager and deputy, a reception manager, four practice nurses, an advanced nurse practitioner, two health care assistants, two phlebotomists, and additional administration staff.
Patients using the practice also have access to health visitors, counsellors, social services carer support workers, district nurses, chiropodists and midwives who are co-located on the same site as the practice. Other health care professionals visited the practice on a regular basis.
The practice is open from 7am to 6.30pm Monday to Friday. Appointments are offered between those times. Extended hours are worked from 7am until 8am daily. Outside of these times patients are directed to contact the out of hour’s service and the NHS 111 number. This is in line with local contract arrangements.
The practice offers a range of appointment types including face to face same day appointments, telephone consultations and advance appointments (three months in advance) as well as online services such as requesting repeat prescriptions.
The practice is registered for the treatment of disease, disorder or injury, diagnostic or screening procedures, maternity and midwifery, and family planning services.
Updated
6 December 2018
This practice is rated as Good overall. (Previous rating October 2016 – Good)
The key questions at this inspection are rated as:
Are services safe? – Good
Are services effective? – Outstanding
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Good
We carried out an announced comprehensive inspection at The Falmouth Health Centre Practice on 30 October 2018 as part of our inspection programme.
At this inspection we found:
- The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
- Information sharing and co-ordinated care was effective. The practice held daily meetings which were attended by clinical staff at the practice and other health professionals such as community nurses, health visitors and midwives co-located in the same building.
- Risks to patients were assessed and well managed. For example, legionella checks were in place.
- The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
- 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. All staff we spoke with felt supported by the practice leadership team.
- The practice embraced technology to continuously improve its service to patients. For example, in the use of social media, a website, online appointments and repeat prescriptions.
- The practice sought continuous improvement and shared this with other practices. This included community prescription templates for community nurses (adopted by all the practices in the county) as part of an ongoing improvement programme. Diabetic referral templates and protocols that were shared with all practices in the county. The practice provided technical support to practices to help them integrate these templates into their systems. The benefits to patients included better co-ordinated care and effective, consistent treatment.
- The practice provided a social media page and a website to keep its patients up to date with the latest health guidance and useful healthy lifestyle events taking place at the practice and in the local area.
- On Bank Holidays the practice provided a second duty GP to provide a faster response to patient needs. The practice had a “never say no” policy to providing appointments.
We saw areas of outstanding practice:
- Following a successful pilot, the practice had been amongst the first in the country (and the first in Cornwall) to successfully introduce e-Consult, an innovative online system for patients to access services. E-Consult took the patient through a pathway that altered depending on their enquiry. E-Consult offered a range of self-help solutions for minor illnesses such as consulting with a pharmacist to reduce the need for a visit to the practice. Positive patient feedback about the scheme had been obtained from Healthwatch Kernow. 35 percent of 3,000 users at the practice were able to resolve their health issues without the inconvenience of attending an appointment. E-Consult continued to grow in popularity as more patients adopted new technology.
- GPs at the practice had created a comprehensive range of computer based prompt templates which brought effective care and consistency across the practice. These templates had been created using the latest guidance and enabled accurate and consistent care and treatment to be provided across a range of different areas. Clinical staff used these templates for safeguarding, sepsis, resuscitation, referrals, and bowel screening. The benefits to patients included safer, prompter and more consistent care. The templates had been shared with local practices across Cornwall and adopted as best practice. Thereby improving the health outcomes for the wider population.
- The practice had innovatively reviewed its new patient questionnaire to include new questions which proactively identified military veterans. This was a new development arising from renewed emphasis upon the Armed Forces Covenant enabling priority access to secondary care to be provided to those patients with conditions arising from their service to their country. In an area with strong links to the Royal Navy, there were facilities at the practice to proactively offer health checks including hearing tests in a specialist audio booth to military veterans.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice
Please refer to the detailed report and the evidence tables for further information.