Archived: York Street Health Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at York Street Health Practice on 20 October 2016. Overall the practice is rated as outstanding.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised. Six monthly thematic reviews of reported incidents were undertaken and actions identified to minimise reoccurrence.
• All staff attended a daily ‘huddle’ meeting to discuss any issues which had arisen in the 24 hours preceding the meeting and to review and action any outstanding issues. We saw evidence of minutes from meetings and an up-to-date and ongoing action log.
• There were comprehensive safeguarding systems in place to enable staff to identify any areas of concern, act upon them in a timely manner and protect patients and staff from abuse. All clinical staff had formal safeguarding supervision with a member of the local safeguarding team on a regular basis.
• The practice actively reviewed complaints and how they were managed and responded to. There was open access to the practice manager where complaints could be dealt with as they arose.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Patients’ emotional and social needs were seen as equally important as their physical needs. Patients said they were treated with compassion, dignity and respect.
• There was wide-ranging evidence of multi-agency working, where the practice worked closely with other organisations, such as outreach services, refugee councils and homeless shelters, in ensuring services were provided to meet patients’ needs. We received numerous extremely positive testimonials to support this.
• The practice had regular liaison with the Home Office and refugee camps to ensure there was a cohesive approach and the refugee/asylum seekers had timely access to care and support.
• The practice had strong and visible leadership and governance arrangements in place. Staff said felt very supported by management and the team as a whole and there were supportive mechanisms in place. All staff had access to a psychologist once a month and counselling sessions were available as needed. Staff were supported to attend mindfulness courses.
• There was 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.

We saw several areas of outstanding practice including:

• There were comprehensive systems in place to support safe practice. The whole team was engaged in reviewing and improving safety and safeguarding systems. The review of all incidents and the learning which arose from those was shared with their provider and external agencies, depending on the appropriateness and confidentiality aspects. There was an ongoing ‘RAG rated’ action plan used to capture and ensure all issues or status reports were discussed or actioned at all meetings. (RAG is a system based on Red, Amber and Green colours used to rate issues.)

• Staff were motivated and inspired to offer kind and compassionate care. For example, they provided suitable clothing for children and adults, food parcels, Christmas gifts, paid for transport for patients to attend appointments and raised money to aid patients as needed. The practice had won several awards for the delivery of compassionate care. Most recently, as part of the Pathway Group of organisations who provide services for homeless people, they had recently received the ‘2016 Kate Granger award for delivering outstanding compassionate care’.
• The practice delivered weekly outreach sessions for the homeless. Twice a month clinicians worked through the night, to provide access to health care and support for street sex workers.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice