Marsh Green Medical Practice

We carried out an announced comprehensive inspection at Marsh Green Medical Practice on 16 July 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as outstanding overall.

We rated the practice as outstanding for providing caring services because:

• Feedback from patients was consistently positive.
• There was a strong person-centred culture.
• Patients were truly respected and valued as individuals and were empowered as partners in their care.

We rated the practice as outstanding for providing well-led services because:

• The practice management team and the SSP leadership team were inspirational, progressive, cohesive and innovative with a mature approach and clear purpose. The practice management team were truly compassionate and caring. Quality and integrity were at the heart of what they did resulting in an exceptional caring culture within a strong practice. Opportunities provided for staff development were exemplary.
• The leadership, governance and culture were used to drive and improve the delivery of high-quality person-centred care.
• There was strong collaboration across all staff and a common focus on engaging with patients and other services to improve quality of care and the patient experience.
• The practice embraced social prescribing for the community to ensure patients received timely intervention when they needed it most, signposted them to services that could help them and ensured support was offered locally so the patient population could easily attend appointments.

We have rated this practice as good for providing safe, effective and responsive services because:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.

We saw several areas of outstanding practice including:

• The practice and the patient participation group (PPG) worked collaboratively to educate the patient population on the need for cervical screening and the benefits of early detection. The practice was in the most deprived area, decile one, and historically the practice population was hard to engage. Therefore, the practice and PPG attended numerous local community events held by the local church and spoke to patients and carers on the screening programmes offered, how they can arrange an appointment and the benefits of attendance. The outcome was positive, and the practice had more patients who booked for screening. This was reflected in the increase in percentages from the last published data, indicating the practice was 7% above the CCG average and 9% above the national average.
• Practice champions who were members of the administrative team, for example palliative care and carers’ champions, were trained to safeguarding vulnerable adults and children level three.
• When the new provider took over the contract in August 2018 medication review rates were significantly low at 6% for any medications and 10% for patients four or more medications. The provider allocated additional GP and pharmacist resources and now 100% of patients on any medicines had received a medication review.
• The practice was in an area where life expectancy was below average for male and female patients. The practice had proactively involved themselves in local schemes and initiatives to provide the best possible care for patients and their families. This included giving the local community access to general hygiene products and daily essentials free of charge, such as toothbrushes, toothpaste, baby wipes and bath and shower products. This was with the aim of improving the health and well-being, both physical and mental, of the patient population. We also noted positive affirmation cards were placed on the reception desk for patients to take away. The quotes included “never lose hope”, “Be Strong – because things will get better”, and “It may be stormy now, but it never rains forever.”
• The practice engaged with the “red box project”. This is a community-based, not-for-profit initiative, which aims to support young people throughout their periods by providing free period products. The practice collected feminine hygiene products in collaboration with the local church and made them available for patients in the surgery. There were posters in the waiting area and in the toilets signposting patients to this discreet service.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care