BBC's 'Real Peak Practice' PM Reveals How His Practice Gained Outstanding!

The staff and patients at Baslow Health Centre in Derbyshire starred in BBC2’s ‘The Real Peak Practice’ last year, and have hit the headlines once again after the practice gained outstanding in their latest CQC inspection.

We caught up with practice manager Karl Rex to get his perspective on the excellent result, ask how he and his team went that extra mile, and find out whether the practice will be returning to our screens anytime soon…

The rating you received in your CQC inspection was fantastic, did you expect to gain outstanding?

We were hoping to achieve outstanding in patient care and we would all have been disappointed if we did not get that. During the first hour of the inspection I thought, oh dear, this does not look too good, but then I actually started to enjoy it and relaxed. I felt that we were going to do well, but did not expect the overall outstanding.

What has been the response of your staff and patients to the result?

Staff are proud of getting outstanding, in particular the outstanding for the Caring element, and are pleased to have it officially graded and nationally recognised via the CQC process. Some staff comments were: “I think it’s great – I don’t want to work for a practice that gives anything less”; “we are proud to be part of this practice and team”; and “we always go the extra mile”.

We had to inform patients that we were being inspected, so word quickly got out and the patients avoided attending or contacting the practice on the inspection day.  We could not drag them in - we thought the phones had broken. We received comments such as “the doctors have enough on with this silly inspection” and “we don’t need to trouble the doctors today as they had enough on”. The inspectors witnessed this and commented on the overwhelming patient support we have. Patients afterwards have congratulated us, with some wondering what all the fuss was about.

The inspection team were very professional and put staff at ease and, via their questioning, they gained the evidence that demonstrated our excellent service provision. Although it did feel like an endless demonstration of producing policies and procedures for virtually everything.

You received outstanding in being both Caring and Responsive, why do you think that was? Do you have any tips on how other practice managers can gain outstanding in those areas?

Our main challenge was how we demonstrate our excellent care and responsiveness, by providing it in written evidence. The policies and procedures became academic as we discussed what we actually did with the inspectors. We started this off with our presentation to them. We stepped outside the format of the presentation they had given us and highlighted how the staff work closely as a team and all the extra work we have done.

Our core set of values and our very high ethos of care across the practice involves all the staff, whether admin, dispensary or clinical. The practice has a set group of core values that we work to. Some of those are: a personal touch; everyone matters; doing well by doing good; going the extra mile; and service fit to the patient - not patient fit to the service. Applying these values and our teamwork has gone a long way in securing our outstanding grade.

My tip would be: don’t panic, involve the whole team. Don’t attempt to do this alone. We work as a closely knit team that communicates very well. So I asked staff to think of how they do their job and all of the extra care that they provide and jot it down (it was surprising all the extra we do). This was then collated into a written format that acted as an aide-mémoire during the inspection. This also reminded me what a fantastic team I have.

After that excellent result, are there any areas you would still like to improve on? What do you think you could do to receive outstanding in the other key questions?

Even though we were congratulated on our risk assessments, we now need to produce risk assessments for some of the ‘extra miles’ we go to. An example is being a dispensing practice in a rural location; staff will offer to take out urgent medications to those patients who are mainly housebound, frail or lack transport. We gave many a good example of these scenarios, proving how we go the extra mile. Be careful what you sing about! We had not completed a procedure or risk assessment for this extra caring work!

Like many practices, we have part-time staff and hardly ever have a time when we are all together. So we did not have practice meeting minutes to evidence the sharing of information. I used to take notes and pass on the information. I now need to record each time I pass on the information to form a set of minutes.

The practice received praise for its approach to end of life care, with 97% of palliative care patients who died within the last 12 months dying in their preferred place thanks to the planning and support offered by staff. You must be very proud of those results?

Caring for our end of life patients is one of our centres of excellence. We pull out all stops for these patients and their family.  This may sound corny to those who don’t know us, but I’m sure the ethos of going the extra mile and caring for our patients runs through our veins. We would have been devastated if we did not receive outstanding for palliative care as we are very proud of what we do.

The practice has very close links with the charity Helen’s Trust. How does that association shape your approach to working with terminally ill people?

It does not alter our approach; however it is very useful knowing that Helen’s Trust is just a phone call away and there are no bureaucratic forms to complete.

Baslow Health Charity Run

Picture of the team and family dressed as superheroes, taking part in the Chatsworth 10km, raising money for Helen's Trust.

It’s been around a year since we last spoke – since then, what would you say have been the biggest changes in primary care, positive and negative, for you as a practice manager?

Partnership or collaborative working is currently my biggest challenge - how practices can work together yet maintain their own identity. This seems to be the way forward, or so we are led to believe, yet it is a difficult one.

You told us last time around that some of your patients were asking about the possibility of a follow-up programme to The Real Peak Practice. Is anything in the works?

Great news - the BBC have already started filming the second series, which is due to air in spring 2017.

Finally, what would you say are your top 3 priorities/must do’s for practices?

Top Tips

FPM members can access the CQC Guidance Area for help and support with their own CQC inspections. First Practice Management (FPM) Group would like to thank Baslow Health Centre’s Practice Manager Karl Rex for the interview.


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