1. The XXX Medical Centre Address Contact details

2. The Practice The practice comprises of (GP Partners, Salaried GP’s, Business/Practice Manager, Nursing staff, admin etc.) Any Special interests Training Practice

3. Practice Population AgeMaleFemale Include some information on the catchment area and prevalence plus any local housing developments, nursing and residential homes etc You may also wish to either add a column showing ethnicity or just add some details

4. IT Which clinical system Fully computerised path links, discharge summaries etc. Online appointments booking and prescriptions On line access to records Electronic Path Lab requests Electronic prescriptions

5. Appointments in hours and extended hours How are they booked/phone/online/in advance, on the day. Extended hours, how many, when and the benefit to which patient group(s)?

6. QOF QOF achievements Any particular issues Intelligent Monitoring issues

7. How do you meet the needs of: Older People People with Long term conditions Families Children and young People Working age People (including those recently retired and students) People whose circumstances may make them vulnerable People experiencing poor mental health, including people with dementia * see sheet on population group descriptors

8. Safeguarding Who is your lead - for Adults and for Children? Are staff aware of who this is, and are aware of the potential issues with vulnerable adults and children Are all GPs and staff aware of the Mental Capacity Act and Deprivation of Liberty Safeguards?

9. Federations Do you belong to a federation, collaborative/provider group? What projects have you been involved in with your group and how has this benefited your practice and patients - what are you doing over and above normal GMS?

10. PPG It is good to have at least one member of the PPG at the practice on the day, tell them about the group and anything they have identified and achieved for the patients and the practice Include any survey results and any outcomes from those

11. Complaints and Significant events Examples of complaints and any learning outcomes Ditto for SEA Examples of any compliments – what are you most proud of?

12. Training and Education Staff appraisals in place? In house education/protected learning time How this benefits the patients and the practice Training for both clinical and non clinical staff