Archived: The Keys Family Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Keys Family Practice on 5 December 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed in most areas, with the exception of systems for monitoring locum recruitment checks and systems in place for managing pathology results. Following the inspection the practice provided evidence of where they had gained assurance that appropriate recruitment checks for locums had been carried out.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Clinical audits demonstrated quality improvements and staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Although the practices performance relating to national screening was below local and national averages in some areas the practice demonstrated actions taken to increase breast and bowel cancer screenings.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients are able to access appointments and services in a way and at a time, that suits them, with urgent appointments available the same day. Results from the July 2016 national GP patient survey showed that patients were satisfied with how they could access care and treatment.
• The practice demonstrated innovative approaches to providing integrated care. For example, the practice provided a contingency service to manage the overflow of patients accessing urgent care services during the 2015 Christmas period.
• The practice had good facilities and was well equipped to treat patients and meet their needs. Clinical staff attended local community venues to provide basic life support training.
• 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.
• The provider was aware of and complied with the requirements of the duty of candour.

The practice used their knowledge of the local community and patient population as levers to deliver high quality, person centred care. There were clear systemic processes in place and a strong learning culture with development opportunities for all staff. The practice was well organised and made full use of their resources to respond to population needs. We saw areas of outstanding practice which were:

• The practice effectively used media and work with other health care professionals to respond to the needs of specific patient population groups to support the promotion of health needs such as self-directed diabetes care and management. The practice identified a high prevalence of registered Punjabi patients diagnosed with diabetes. The practice secured funding with Walsall CCG and worked closely with the community diabetes services and a National TV channel to develop an educational program for patients regarding diabetes care. The programme was developed in mixed English and Hindi languages to reach out and capture wider audiences such as Hindi, Punjabi and Urdu speaking audiences. We were told that the programme was now used by the community diabetes service when delivering educational events.
• The practice proactively worked with community services such as the local fire service to offer vulnerable patients safe and well visits and delivered basic life support training to children and adults in local community settings.

The areas where the provider should make improvement are:

• Consider in the absence of infection control training how non clinical staff maintain up to date knowledge to enable them to fulfil the requirements’ of their role.
• Continue exploring ways of encouraging the uptake of national screening programmes such as bowel and breast cancer.
• Consider how assurance is gained and recorded from agencies to demonstrate that appropriate recruitment checks are in place for all locum GPs.
• Ensure roles are defined and accountability made clear to enable effective management of pathology results.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice