Letter from the Chief Inspector of General Practice
This is the report of findings from our inspection of Irlam Medical Practice. The practice is registered with the Care Quality Commission to provide primary care services.
We undertook a planned, comprehensive inspection on 2 October 2014. We spoke with patients, staff and the practice management team.
The practice is rated as Outstanding. An innovative, caring, effective, responsive and well-led service is provided that meets the needs of the population it serves. Our key findings are as follows:
The service is safe. There are systems in place to address incidents, deal with complaints and protect adults, children and other vulnerable people who use the service. Significant events are recorded and shared with multi professional agencies and there is evidence that lessons are learned and systems changed so that patient care is improved.
The service is effective. There are systems in place to support the GPs and other clinical staff to improve clinical outcomes for patients. According to data from the Quality and Outcomes Framework (QoF), which is the annual reward and incentive programme detailing GP practice achievement results, outcomes for patients registered with this practice are above average for the locality. Patient care and treatment is considered in line with best practice national guidelines and staff are proactive in promoting good health.
The service is caring. The practice are pro-active in obtaining as much information as possible about their patients including carer status, family dynamics, dependency and any other outside influences which do or can affect their health and wellbeing. All the staff know the practice patients very well, are able to identify people in crisis and are professional and respectful when providing care and treatment.
The service is responsive. The practice plans its services to meet the diversity of its patients. There are good facilities available, adjustments are made to meet the needs of the patients and there is an appointment system in place which enables good access to the service.
The service is well led. The practice has a clear vision and set of values which are understood by staff and made known to patients. There is a clear leadership structure in place, quality and performance are monitored and risks are identified and managed.
We saw areas of outstanding practice. For example :
- All the practice staff proactively follow up information received about vulnerable patients. We saw five examples where clinical and reception staff had used their initiative when they had raised a concern or passed on information which led to a positive outcome for the patient.
- The practice also reaches out to the local community. The practice nurses voluntarily carry out an annual stroke awareness clinic at a local supermarket for the whole community and have been doing this for the last five years.
- We saw excellent examples of close working partnerships with other health and social care professionals which includes care planning. Care Plans are in place for two per cent of the practice patients as part of a national enhanced service and with a view to avoiding unplanned admissions to hospital.
- Clinical audits are undertaken on a regular basis and results from those audits are used to improve the quality of services provided. An infection control audit checked that patients using nebulisers were educated in routine maintenance of their machines to reduce the risk of bacterial contamination and advice was reinforced during annual reviews of their care.
- Significant events are recorded and shared with multi-professional agencies in and outside the practice. We saw evidence that lessons are learned and systems changed so that patient care is improved.
- There is good leadership and a strong learning culture within all the staff who have a clear vision with quality and safety as their top priority. Staff respond to change and are encouraged to bring suggestions for improvement. We saw a high level of constructive staff engagement and staff satisfaction.
There were areas where the practice should improve. For example
- The practice did not pro-actively obtain and record feedback from patients about minor surgery and did not regularly encourage people to comment about their care and treatment.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice