'Requires improvement' practice transforms CQC rating into 'outstanding'

A GP practice in Norfolk has become the first to improve its CQC rating from requires improvement to outstanding in a single step, joining a select group of practices with top marks from inspectors.

The Litcham Health Centre in Kings Lynn, Norfolk, has had its rating upgraded to outstanding less than two years after inspectors initially ordered it to make improvements.

Only the top 4% of practices – one in 25 across England – have been awarded outstanding ratings to date, with the vast majority given the rating after their first inspection.

Three practices have been upgraded from good to outstanding, but the Litcham Health Centre is the first to make such significant improvements since the CQC launched its four-point rating scale.

The practice was first inspected in February 2015 and rated requires improvement overall as well as for being safe, effective and well-led. It received good ratings for being caring and responsive.

But its follow-up inspection 21 months later in November 2016 found the practice had transformed itself, winning an outstanding rating overall and for all points except safe, which was rated good.

Map: CQC GP ratings

The CQC told GPonline that inspectors had been impressed with how ‘responsive’ the practice had been to comments made in its first report. ‘Exceptional’ patient feedback had shown what a positive impact the practice’s changes had made.

Among a host of recommendations, it was initially told to improve its safe management of medicines, ensure that risks to patients were assessed, ensure staff receive mandatory training and improve the process of reporting significant events.

Upon their return, CQC inspectors found that the practice had made a host of improvements. The outstanding report says the practice ‘maximised’ all opportunities for learning from internal and external incidents and used ‘innovative and proactive methods’ to improve patient outcomes.

Inspectors received 187 patient comment cards – representing the views of 5% of the patient list – and found the comments were ‘consistently and strongly positive’.

Outstanding practice

The practice had started to employ a specialist community support team to ensure that housebound patients could be assessed and receive support in the community.

This team uses ‘priority boards’ to keep up to date with changes in the care of patients on different registers, which has led to a reduction in A&E admissions and inappropriate hospital referrals.

A CQC spokeswoman said: ‘In brief, the practice was very responsive to the comments in the first report and improvements that needed to be made. They did not have a management team for the first inspection and quickly employed a very talented multi-skilled team. All issues within the dispensary had been overcome.

‘They were also innovative when responding to local challenges, for example the poor access to community services in a very remote area, and had employed an experienced and adaptable team of community matrons, nurses and healthcare assistants.

‘Additionally, they had made further progress in their use of information technology to improve patient outcomes. Their patient feedback was exceptional and this shadowed the positive impact of the work undertaken by the practice.’

The CQC is scheduled to complete all GP inspections and ratings by 31 March this year.

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