Monthly column for providers and professionals working in primary medical and dental services from Prof. Steve Field, Chief Inspector of General Practice

In this month’s column I want to talk about what we can do in primary care to play a part in combating sepsis, a potentially life-threatening condition if not identified and treated. As is also customary in my monthly column, I would like to shine a light on an outstanding practice and some of the things they did to achieve their rating.


Sepsis is a term used to describe the body’s abnormal response to infection. It can affect anyone but is more common in people who have a weakened immune system, a long-term condition, are very young or are frail. It is a potentially life-threatening condition and kills 44,000 people a year in the UK.

In last month’s bulletin we signposted to a campaign from Sepsis Trust to help dental providers recognise the signs of sepsis. In primary care more broadly, we may not encounter sepsis frequently but early detection is vital.

Our Senior National GP Advisor has published further information on what to look for when identifying signs of sepsis as well as a number of examples of good practice that we have found on our inspections. These include ensuring all staff are adequately trained in identifying sepsis and having proper triage processes in place to provide a rapid response to possible cases.

Celebrating outstanding practice

We recently published an inspection report for Tillingham Medical Centre, rating them as outstanding in four of key questions, as well as for four population groups. As a practice they are doing some truly innovative and positive work with the local community and I want to use this month’s column to share some of that work.

Following a successful pilot in collaboration with the local community provider, the practice decided to part funded a primary care matron. As part of the role, the matron visited patients that had been discharged from hospital to safeguard against any potential future admissions. Picking up on the theme from our Beyond barriers report that I talked about in my column last month, the matron also developed joint assessments with external agencies to ensure a fully holistic approach to the management of patients with complex healthcare requirements. As a result of this holistic and system-wide approach to caring for the needs of the practice’s patients, they were able to demonstrate the second lowest for unplanned admissions to hospital in the clinical commissioning group.

Another area in which the practice excelled was in finding innovative and creative ways to treat patients with learning disabilities. Working in close collaboration with the local home they created a visual pain scale for patients with learning difficulties to use, enabling them to build a rapport and ensure continuity of care. The practice worked hard to cater its services to those patients with similar needs by ensuring that appointments were given at a suitable time and often looked to offer the last appointment of the day to ensure the environment was calm.

As always, we highlight any areas of outstanding practice at the start of our inspection reports, as well as drawing out some previous examples onto our website. It is a strategic commitment for CQC to encourage improvement and innovation in care and we will continue to do more in this area as we move through our strategy for 2016–21.

Have a great month everyone.


We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

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