Archived: The Lawn Medical Centre

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. Previous inspection October 2014 – Good across all domains

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

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 – Good

Families, children and young people – Good

Working age people (including those recently retired and students) – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Lawn Medical Centre on 1 November 2017, as part of our inspection programme.

At this inspection we found:

• The practice had good systems to manage risk so that safety incidents were less likely to happen. When they did happen, the practice learned from them and improved their processes.
• 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 people 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 strong focus on continuous learning and improvement at all levels of the organisation.
• 97% of patients who responded to the NHS national survey said the GP gave them enough time compared with the Clinical Commissioning Group (CCG) average of 84% and national average of 86%.
• The patient participation group (PPG) was well engaged and represented a diverse range of ages and backgrounds. The PPG liaised closely with a Community Navigator, employed by Swindon Borough Council, to support people who attended their GP surgery but did not necessarily require medical care. Patients were supported with issues such as social isolation and coping with caring responsibilities, and were connected to services and groups that could help improve their wellbeing and meet their wider needs. The PPG suggestions for changes to the practice management team had been acted upon and the group had raised awareness to patients about practice services generally.

• Staff had lead roles that improved outcomes for patients such as a carers’ lead.
• 93% of patients who responded to the national GP survey said they could get through easily to the practice by phone (CCG average 69%, national average 71%).
• 91% of patients who responded said their last appointment was convenient (CCG average 76%, national average 81%).
• Daily GP triaging of patient calls reduced the number of unnecessary appointments booked and therefore enabled the greater available of on-the-day appointments. We saw documentary evidence that the number of calls triaged in one month, that did not lead to a visit to the practice, home visit or referral to another service, led to on-the-day appointments.
• There was a proactive approach to understanding the needs of different groups of people and to deliver care in a way that met these needs and promoted equality. Lawn Medical Centre identified patients at risk of developing diabetes who were not on the diabetes register, and implemented changes that could help to delay or prevent the progression of this health condition. Changes offered to patients included lifestyle interventions and annual blood testing. The practice routinely referred patients to the DESMOND service. DESMOND is the name for a group of self-management education modules, toolkits and care pathways for people with, or at risk of developing, Type II diabetes. In the last 12 months, the practice had 36 patients with a new diagnosis of diabetes, all of whom were referred to the DESMOND service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice