Primecare Medical Centre

Updated 13 January 2017

This practice is based in a residential style house at the end of a road there is limited car parking available. The practice has a general medical services contract (GMS).

The current list size of the practice is under 2000 patients. There is one female GP who covers seven sessions and one male GP who covers one session a week for those patients who prefer a male doctor. There is one female practice nurses and a number of other staff carrying out administrative duties.

The practice is open between 8am and 6.30pm Monday to Friday. Appointments are from 9am to 11am and 3.45pm to 6pm Monday to Friday. There is extended hours every Wednesday from 6.30pm to 7.30pm.

Thurrock Clinical Commissioning Group (CCG) has recently launched a weekend system called ‘Thurrock Health Hubs’. Patients are able to book through the practice to see either a doctor or a nurse between 9.15am and 12.30pm at the weekend, at one of four ‘hubs’. The practice premises houses the local weekend ‘hub’.

When the practice is closed patients are advised to call 111 if they require medical assistance and it cannot wait until the surgery reopens. The out of hour’s service is provided by IC24.

There are slightly higher than local and national average levels of income deprivation affecting older people in the practice population. The patient population age profile is similar to the local and national average with the highest number of patients in the 14-18 years old age bracket.

Updated 13 January 2017

Letter from the Chief Inspector of General Practice

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients’ responses on our comments cards told us that patients thought staff were caring and helpful, and that they felt listened to by the clinical staff.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• The patients we spoke with and responses on our comments cards told us that the majority of patients were satisfied with the service received by the practice.
• The practice facilities met the needs of most of its patient population. There was no hearing loop or other equipment to aid those with a hearing deficit.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The culture of the practice was open and honest, and the practice complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Improve the identification of patients who are carers.
• Consider the installation of a hearing loop or other similar equipment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 13 January 2017

The practice is rated as good for the care of people with long-term conditions.

• The main GP had the lead role in long term conditions management, although the practice nurse was responsible for the reviews of patients with COPD and asthma.
• The practice performance for diabetes indicators was above the CCG and national average. For example, the percentage of patients with diabetes with a record of an annual foot examination and risk assessment was higher than the CCG and national averages.
• Longer appointments and home visits were available when needed.
• The practice told us that patients were reviewed on a nine monthly basis if stable and six monthly otherwise.
• Practice staff worked with relevant health and care professionals to deliver a multidisciplinary package of care.
• The practice had links to information and support on the main types of long term conditions on its website.

Updated 13 January 2017

The practice is rated as good for the care of families, children and young people.

• There were systems and processes in place to enable staff to identify and take appropriate action to monitor and safeguard children and young people living in disadvantaged situations. For example, children with a large number of A&E attendances.
• Immunisation rates were in line with or slightly lower than CCG and national averages for standard childhood immunisations. However low numbers of children on the practice list may skew the data.
• Patients told us that children and young people were treated appropriately.
• Pre-bookable appointments were available at the GP ‘hub’ at the weekend. Weekday appointments were available at the end of school hours.

Updated 13 January 2017

The practice is rated as good for the care of older people.

• Patients had a named GP.
• The practice was accessible for those with limited mobility.
• The practice offered personalised care to meet the needs of the older people in its population, they worked with patients and their families to ensure was achieved.
• The practice was responsive to the needs of older people in their practice population. They provided information about community facilities to these patients and worked with multi-disciplinary teams from health and social care to keep patients in their own homes where this was their preference.
• The practice offered planned home visits for patients with enhanced needs, as well as urgent ones.

Updated 13 January 2017

The practice is rated as good for the care of working-age people (including those recently retired and students).

• Pre-bookable appointments were available at the GP ‘hub’ at the weekend.
• Later appointments were available on Wednesdays from 6.30pm to 7.30pm.
• The practice had available online access to register with the practice, book and cancel appointments and request repeat medicines.
• The percentage of women aged 25-64 who have had a cervical screening test in the past 5 years was in line with the CCG and national average.

Updated 13 January 2017

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• The percentage of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months was in line with the CCG and national average.
• Performance data for the number of patients with a mental health diagnosis with an agreed care plan recorded in their record in the last 12 months was higher than CCG and national average.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice sign-posted patients experiencing poor mental health to various support groups and voluntary organisations.

Updated 13 January 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances such as those with a learning disability.
• The practice offered longer appointments for those patients who needed them.
• The practice worked with other health care professionals as needed in the case management of vulnerable patients.
• The practice sign-posted vulnerable patients to various support groups and voluntary organisations.
• Staff had received training in identifying and reporting possible signs of abuse and the practice kept registers of different groups of people whose circumstances make them vulnerable.
• The practice had identified 13 carers which was 0.5% of the patient list. The practice signposted its carers to support services.
• The practice did not have a hearing loop for patients who had a hearing deficit.