We carried out a review of the data available to us about Peartree Medical Centre on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Peartree Medical Centre, you can give feedback on this service.
We carried out an announced comprehensive inspection at Peartree Medical Centre on 13 September 2016. Overall the practice is rated as outstanding.
Our key findings across all the areas we inspected were as follows:
The assessment and management of risks was comprehensive, well embedded and recognised as the responsibility of all staff. This included safeguarding children and vulnerable adults from abuse and health and safety.
Sufficient staff were employed to meet patient’s needs and this included employing “bank/casual staff” to enable flexible and immediate access to staff in response to service demands.
Staff had the skills, knowledge and experience to deliver effective care and treatment. They assessed patients’ needs and delivered care in line with current evidence based guidance.
The practice has consistently maintained a track record of high quality outcomes framework (QOF) performance over the last five years with achievements above 99%. The 2015/16 nationally reported data showed all patient outcomes were in line with or above the local and national averages.
We saw several examples of collaborative working and sharing of best practice to promote better health outcomes for patients. Specifically, ongoing health education programmes relating to cancer screening, diabetes, stroke and children’s health with demonstrable impact of positive outcomes being achieved for patients.
Clinical audits and regular reviews of the service were undertaken to drive improvements to patient outcomes.
Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
Significant improvements had been made over the last two years to improve telephone access and availability of appointments. Most patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
The practice actively reviewed the management of complaints and made improvements as a result. An annual review was undertaken to detect themes and trends.
The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
The practice had strong and visible clinical and managerial leadership and governance arrangements.
A strong ethos of continuous improvement was owned by all staff.
We saw several areas of outstanding practice including:
There was an open and transparent approach to safety and an effective system for managing and significant events. Significant events were fully investigated and learning was shared with the practice team, other stakeholders and the national reporting and learning system (NRLS). The NRLS ensures the learning gained from the experience of a patient in one part of the country is used to reduce the risk of something similar occurring elsewhere. An annual “significant event analysis and reflection” report was produced and discussed with staff to ensure learning had taken place and changes were embedded.
There was an on-going programme of patient education and wider external stakeholder engagement to tackle health inequalities affecting patients and the wider community. For example:
The practice held health educational meetings at least three times a year at the local community centre to improve the take up of breast and bowel screening. The impact of these events and opportunistic screening had resulted in an increased uptake rate of 20% for bowel cancer over the last 14 months. This data was yet to be verified and published nationally. The 2014/15 data showed the practice’s uptake for the cervical screening programme for the preceding five year period was 96% which was significantly above the local average of 84% and the national average of 82%.
The practice used proactive methods to improve outcomes for patients living with and at risk of diabetes; taking into account their religion. For example: 30 patients had attended a health education event titled “managing your diabetes during Ramadan” at the practice. Some patients had also attended the social cooking project facilitated by the Derby City Public Health team to encourage use of lower levels of saturated fat and salt intake by south Asian families who are at higher risk of developing diabetes. The performance data for diabetes related indicators was 100% compared to the local average of 92.9% and the national average of 89.9%. The practice had double the clinical prevalence of diabetes when compared to the local and national averages.
The practice had identified patients at high risk of developing diabetes. This enabled the clinicians to support and advise patients on changes required to prevent diabetes developing
The practice proactively identified and supported its carers with support from Derbyshire Carers Association. A total of 207 patients had been identified as carers and this represented 4.6% of the current practice list. Carers assessments were undertaken from the practice with evidence of personalised support plans being put in place to address the carers needs.
Innovative approaches were used to gather feedback from the practice population. For example, the patient participation group (PPG) consisted of at least 30 active members. It was unique in that it comprised of a main group including both men and women; and a ladies only PPG meeting was facilitated for female Asian patients in response to underrepresentation in the main group, cultural, religious and personal preferences. At the time of the inspection at least nine female members attended the meetings. This removed barriers to gender inequality and promoted holistic feedback for the practice team which it acted upon.
The practice team had a proactive approach to understanding the cultural diversity and language needs of its practice population to ensure equal access to services and continuity of care. Since 2003, the practice has employed an interpreter (four days a week) who speaks Urdu, Mirpur Punjabi and Hindi and some other Asian dialects less proficiently. An evaluation of their role demonstrated a high level of satisfaction by patients and positive outcomes for clinicians whose first language was not English. For example, the interpreter had been supported with additional training on medical terminology and procedures to ensure consistent explanations were clearly given to patients and clinicians times was efficiently managed during the appointment. The interpreter also regularly signposted patients to a range of services that deal with benefits, housing and education. The telephone system had also been improved in 2014 and included an automated welcome message and options in Urdu.
However there were areas of practice where the provider should make improvements:
Continue to review, monitor and act upon patient experience data to continually drive service improvement.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice