Letter from the Chief Inspector of General Practice
This practice is rated as Outstanding overall. (Previous inspection January 2015 – Good)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Outstanding
Are services caring? – Good
Are services responsive? – Oustanding
Are services well-led? - Outstanding
As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:
Older People – Good
People with long-term conditions – Outstanding
Families, children and young people – Outstanding
Working age people (including those retired and students – Good
People whose circumstances may make them vulnerable – Outstanding
People experiencing poor mental health (including people living with dementia) - Outstanding
We carried out an announced comprehensive inspection at Bentley Surgery on 4 December 2017 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.
- The practice routinely reviewed the effectiveness and appropriateness of the care it provided. Care and treatment was always delivered according to evidence- based guidelines, for example in relation to prescribing medicines for an irregular heart beat.
- Frail older people were well supported by the practice-employed care coordinator and their engagement with social prescribing.
- Staff involved and treated patients with compassion, kindness, dignity and respect.The practice was above average for its satisfaction scores on consultations with GPs and nurses.
- Patients found it easy to use the appointment system and reported that they were able to access care when they needed it.
- There was innovation and service development and improvement was a priority among staff and leaders.
- Data showed that the practice was performing highly when compared to practices locally and nationally.
- At the core of the practices ethos, was learning and development across all staff groups.
- Feedback from patients was consistently positive and higher than local and national averages.
We saw areas of outstanding practice:
- The practice used innovative and proactive methods to improve patient outcomes and worked with other local providers to share best practice. In October 2016 the practice linked with three neighbouring practices to hold quarterly meetings with the wider multidisciplinary team which included a respiratory nurse, community geriatrician, a representative from the local social prescribing initiative, palliative care nurses, district nurses, heart failure nurse, social services and the falls team. This provided the opportunity to review those patients considered most at risk and a forum for sharing best practice and learning through review of case studies.
- The practice ensured that patients with complex needs, including those with life-limiting progressive conditions, were supported to receive coordinated care in innovative and efficient ways.The practice employed a care co-ordinator nurse to review and implement care plans for those patients whose circumstances may make them vulnerable. Initially, patients were assessed using a risk stratification tool which included review of patients living with dementia, learning difficulties, frailty, at risk of hospital admission, housebound, residing in care home or those with multiple long term conditions. The care co-ordinator had identified 140 patients at risk and 89% of these patients had consented to an enriched summary care record.
- Staff encouraged and supported patients to be involved in monitoring and managing their health.For example, a GP encouraged a group of patients to establish a support group for people with fibromyalgia. (Fibromyalgia is a long term condition that causes pain all over a persons body). The group met monthly at the practice and people from other practices were invited. The GP would attend with updates about therapies and treatments.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice