Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at St Mary’s Health Centre on 28 April 2015. Overall the practice is rated as outstanding.
Specifically, we found the practice to be good for providing safe services, and outstanding for providing effective, caring, responsive and well-led services. It was also outstanding for providing services for all the population groups of older people; people with long term conditions; families, children and young people; people experiencing poor mental health; people who are vulnerable; people of working age and those recently retired.
Our key findings across all the areas we inspected were as follows:
- Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and improvements made.
- Risks to patients were assessed and well managed, including those relating to recruitment checks. Suitable staff recruitment, pre-employment checks, induction and appraisal processes were in place and had been carried out. Staff had received training appropriate to their roles and further training needs had been identified and planned.
- Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and carried out to enhance the service for patients.
- Patients said they were treated 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 and easy to understand.
- Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
- The practice had good facilities and was well equipped to treat patients and meet their needs.
- 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.
We saw several areas of outstanding practice including:
- The leadership, governance and culture at the practice were used to drive and improve the delivery of high quality person-centred care. The GPs had visited Sweden and looked into the Esther Project which focussed on ensuring patients received care in or close to home and knew where and who to turn to for care; it helped patients see the healthcare system as an entity working together to provide good quality care. Staff discovered that most patients wanted to receive as much care in their home or as nearby as possible. If they had to go to hospital, the patient preferred to leave as soon as feasible and have their continuing care needs met at home. To fulfil these principles the GPs at the practice had developed services and obtained additional skills to provide optometry, blood testing, x-rays, ultra-sound scans, and had integrated patient care between all caring agencies on the islands. This had significantly reduced the need for patients to travel by sea or air to hospitals on the mainland, for example we were shown evidence that demonstrated at least 80 patients had received and ultra sound tests, 94 patients had received blood tests and approximately 130 patients had optometry testing.
- Being a close-knit community, to ensure patient confidentiality and encourage younger patients to care for their health, a separate telephone line direct to the GP was available to help protect confidentiality and encourage young people to access services. The practice is an accredited member of a scheme specifically for young people given the name and known as EEFO. The scheme is aimed at young people aged 13 to 19 living in Cornwall and the Isles of Scilly and addresses the barriers identified by national and local research which prohibit young people from accessing the services they need.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice