How we achieved an ‘outstanding’ rating in our CQC inspection
GP-first triage and a proactive approach to the Friends and Family test helped us secure an ‘outstanding’ rating, says Salford Health Matters’ chief executive Neil Turton
Name Salford Health Matters
List size 15,000
Full-time equivalent GPs 8
Inspection date 3 October 2014
The CQC praised our access policy
It was seven years of hard work rather than two weeks of preparation that got us ready for the CQC inspection. The Doctor First appointment system, which we’ve used for two years, helped us perform well. Our GPs speak to all patients who request a consultation on the phone, which gives us the capacity to meet demand on the day because we find that 60% of patients can be safely managed through the call. It also gives GPs more control over how long each consultation lasts. However, we have to balance access with continuity of care – we can’t guarantee that patients needing urgent attention would be able to see the GP requested. But overall, the system has improved safety, effectiveness and enabled us to provide better care.
Inspectors noted the benefits of running our three sites as if they’re one practice
Salford Health Matters is made up of three practices on different sites across an area of several miles, so we use centralised functions to run them as one. This helps improve access because patients can attend any practice in the group and we also offer Saturday or late-night openings. We’ve also got a common IT system so clinicians can access the notes of any patient, as well as viewing appointment bookings for all practices. Having a central business unit and HR team has also enabled us to economise – otherwise we would never have made it financially.
Our patient feedback system was commended
We are delighted to have been rated ‘outstanding’ by the CQC, but we don’t get it right all the time. However, the one thing we are really committed to is fixing things if they go wrong. Since November 2013, we’ve run the Friends and Family Test on a weekly basis. Then, we text patients who have indicated they’re ‘extremely unlikely’ to recommend us to find out what we can do better. The senior management team tackles overarching problems, while reception staff are asked to come up with pragmatic solutions.
The CQC recognised that our staff create a patient-centred culture
The heart of our success in the inspection was having a team who go the extra mile to offer good patient experience. We look for recruits with excellent communication skills, who are interested in preventive health and working in a not-for-profit organisation.
Our GP roles could be described as ‘salaried plus’, offering development and leadership opportunities, while our advanced nurse practitioners hold masters-level qualifications.Our team is non-hierarchical and we have a performance development review process, regular one-to-ones with employees, and we pay our reception staff on Agenda to Change terms.
We have had to grow our list to maintain income
We haven’t made a significant profit since we started. In the last three years of our APMS contract the contract value was reduced by £100,000. When we changed to the PMS contract, we took another £100,000 hit. To keep our income steady, we’ve diversified and grown our list – we began with 11,500 patients and now have 15,000 and we’ve taken on a homeless service and a specialist children service.