CQC chief reveals what defines 'outstanding' general practice and names top two

Two practices that cater for homeless patients have been praised as the best in the country by the CQC's chief inspector, after the watchdog completed the process of rating every GP practice in England.

Professor Steve Field
Professor Steve Field

Professor Steve Field named Bevan House in Bradford and Inclusion Health in Leicester as the ‘the two most amazing surgeries’ he had been to in an interview with GPonline.

Both practices appear to be far from typical, and stand out for making special provision for homeless patients. They are both run by community interest companies under APMS contracts.

Professor Field was speaking at the launch of the CQC’s comprehensive review of all practice ratings in England, which shows 4% of practices were given the top rating.

When quizzed on what features tended to define an outstanding practice, he told GPonline: ‘What I say is it’s about leadership – strong clinical leadership and really good practice manager leadership as well.

‘Where these practices have done really well, they have a clear vision and a clear understanding. They focus on the needs of their particular patient groups and also work closely across the health economy.’

Bevan House

CQC reports show that Bevan House was awarded outstanding ratings for all five key questions, for being safe, effective, caring responsive and well-led and outstanding for care provided to all population groups.

It has 3,500 registered patients – of which only 0.1% are aged over 75 – and houses eight part-time GPs, a vulnerable migrants nurse, a mental health nurse and a fulltime healthcare assistant.

Bevan House was featured as a case study in the CQC's state of care report for a scheme that found it saved between £1.50 and £8.00 for every £1.00 invested in its programme for homeless patients.

The report said: ‘The Bevan team worked with the Bradford Respite and Intermediate Care Support Service (BRICSS), which is run by a social housing provider and provides accommodation, with Bevan Healthcare providing medical care for residents.

‘It offers respite accommodation for homeless patients who need medical care after they are discharged from hospital. Bevan’s Street Medicine Team also held mobile outreach clinics in city centre locations to enhance access for vulnerable patients and also offered advice and healthcare to people who were not registered with the practice.

‘These initiatives led to an increase in the number of homeless people registering with the practice, a reduction in the use of acute health care, A&E admissions and days spent in hospital.

'A review conducted by an external agency of BRICCS, the Street Medicine Team and the Pathway Team found that for every £1 invested in these services the savings were from £1.50 to £8.00.

‘The Bevan Pathway team was noted to have reduced acute health care costs by 62% by supporting homeless patients in primary care settings.’

The practice also offers a number of ‘above and beyond’ services for patients, including an Arabic interpreter, an annual Christmas party for vulnerable children and a thrice-monthly evening clinic for female sex workers.

Inclusion Healthcare

Inclusion Healthcare, which was among the first practices rated outstanding, was also found outstanding on all points.

It provides care for homeless patients and has one fulltime GP and four part-time GPs, in addition to two practice nurses, a primary care plus nurse, a specialist alcohol worker and a healthcare worker.

Inspectors praised it for having a healthcare assistant accompany homeless patients to hospital referrals and contributing towards funeral costs for homeless patients.

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