Martello Health Centre

Updated 26 March 2018

Martello Health Centre is managed by Invicta Health and Community Interest Company. They registered with the Care Quality Commission in January 2015 to provide regulated activities. They hold an Alternative Provider Medical Services contract and provide services to approximately 4,700 registered patients with a 40% weighted list equalling 6,580 patients. They provide care to an ageing population with complex needs and patients in specialist care homes.

The clinical team consists of four GP locums (three male and one female), two full time and one part time nurse practitioner, three practice nurses (one specialising in chronic disease management) and one assistant practitioner (all female). They are supported by an administrative team overseen by a practice manager. The practice also employs a clinical pharmacist who is a non-medical prescriber, a paramedic practitioner and a community matron specifically aligned to work with the practice patients over 75 years of age.

The practice is open from 8am until 6.30pm Monday to Friday. Appointments are available from 8.30am to 11.30am and 2.15pm to 5.30pm. On the day appointments are released every morning at 8am and urgent appointments are available for patients that need them. In addition to pre-bookable appointments there are appointments that can be booked up to six weeks in advance with GPs and three months in advance with the nursing team. Saturday clinics are held seasonally to promote uptake of influenza vaccinations. There is limited onsite parking available for patients.

When the practice is closed patients requiring non-urgent care are advised to call the national NHS 111 service for advice or use the Health Helps Now, a service for signposting patients to health provision in Kent and Medway. Out of Hours provision is provided by Primecare.

Updated 26 March 2018

We carried out an announced comprehensive inspection at Martello Health Centre on 16 May 2017. The overall rating for the practice was good. The full comprehensive report on the May 2017 inspection can be found by selecting the ‘all reports’ link for Martello Health Centre on our website at www.cqc.org.uk.

A desk-based review was carried out on 5 January 2018 to confirm that the practice had carried out their plan to make improvements to the areas we identified in our previous inspection on 16 May 2017. However, we found patient satisfaction scores from the national GP patient survey still remained low in some areas and the practice needed to improve patient access to services. Consequently, the practice conducted their own patient survey in January and February 2018.

A further desk based review was carried out on 23 February 2018. This report covers our findings in relation to those improvements made since our last inspection.

Overall the practice remains rated as good.

Our findings were:

• The practice conducted a patient survey in January and February 2018. It found not all the findings of the July 2017 national GP patient survey were representative of their patients’ experience. The practice found in four of the six areas where they were previously identified to be below the local and national averages, they were now comparable or above.
• The practice accepted improvements were still required to improve telephone access and the patient experience when making an appointment and were working with their patient participation group to address these areas.

At this inspection we found that the practice provided responsive services for their patients. However, the practice should continue to make improvements by developing and implementing plans to improve patient satisfaction scores with services provided.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 June 2017

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

• Nursing staff had lead roles in long-term disease management and conducted specialist clinics twice a week. Patients at risk of hospital admission were identified as a priority.

• The clinical pharmacist specialised in hypertension and asthma reviews for patients.
• Patients with long terms conditions such as chronic kidney disease, cancer, epilepsy and hypertension. Care for patients with chronic obstructive pulmonary disease was also good achieving 98%. This was the same as the local and national average.
• The practice clinical team (GPs, nurses and clinical pharmacist) followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.
• There were emergency processes including care plans in place for patients with long-term conditions who may experience a sudden deterioration in health.

Updated 21 June 2017

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

• The practice followed up on children who failed to attend appointments and there were systems to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of accident and emergency (A&E) attendances.

• The practice followed up on all children with an incomplete vaccination schedule and their overall childhood immunisation rates were found to be good.
• Patients told us, on the day of inspection, that children and young people sometimes experienced difficulties obtaining appointments but were treated in an age-appropriate way.
• The practice offered Chlamydia screening to patient’s 15-25years of age.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice provided sexual health and family planning advice. They worked with midwives to support patients in the provision of ante-natal, post-natal and child health surveillance clinics.

Updated 21 June 2017

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

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.

• The practice nursing team provided wound care, phlebotomy and vaccinations to older people and house bound patients.
• The practice nursing team led on the review and care planning of patients over 75 years of age.
• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.
• Where older patients had complex needs, the practice shared summary care records with local care services.
• Older patients were provided with health promotional advice.
• The practice had commissioned a hearing loop to be installed in the practice and had raised chairs with arms in their waiting areas to assist less abled patients.

Updated 21 June 2017

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

• Temporary residents (such as holiday visitors and seasonal workers) may register with the practice to access their services.
• The practice provided telephone appointments for patients unable to attend in person and seasonal vaccinations some Saturdays.
• The practice was proactive in offering online services as well as a full range of health promotion provided by health trainers and their clinical team.
• Patients were able to receive travel vaccines available on the NHS and were referred to other clinics for vaccines available privately.
• Students were offered the meningitis vaccine.
• Sexual health advice was available including signposting to contraception services for long acting contraception such as implants and coil fittings.

Updated 21 June 2017

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

• The practice achieved full QOF points for their care of patients with dementia and depression.
• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs. Thereby, reducing the opportunity for them to abuse medication and potentially self-harm.
• The staff had received mental health awareness training and the nurse practitioner was a trained dementia friend promoting learning and understanding of the condition.
• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.
• The practice had a system to follow up patients who had attended accident and emergency.
• Patients could access an in house counsellor and Improving Access to Psychological Services providing talking therapies as well as Child and Adolescent Mental Health Services (CAMHS).

Updated 21 June 2017

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

• End of life care was delivered in a coordinated way which took into account the needs and wishes of the patient.
• The practice offered longer appointments for patients with a learning disability at the request of the patient or clinician.
• The practice regularly worked with carers and other health and social care professionals in the case management of vulnerable patients.
• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.
• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.