North Chelmsford NHS Healthcare Centre

Updated 8 August 2017

The practice known as North Chelmsford Healthcare Centre provides services for approximately 4,900 patients in Chelmsford and the surrounding villages. This is an increase of over 2,000 patients in the last two years.

North Chelmsford Healthcare Centre holds an Alternative Provider Medical Services (APMS) contract to provide Primary Care Services. The APMS contract is held by NHS England and the Practice is part of the NHS Mid Essex CCG.

There are currently three GP partners, one GP registrar, one nurse practitioner, one practice nurse and one HCA providing clinical services to the patient population. There are seven administrative staff, a practice manager and a practice pharmacist to support the clinical team.

The Surgery is located in a building, which is separate but attached to the Sainsbury Supermarket.

The Practice carries out a full range of enhanced services and looks after over 100 patients in a residential home within Chelmsford.

The practice population is similar to the national average for younger people and children under four years of age, however there is an extremely high percentage of working age and recently retired people, and a low percentage of older people aged over 75 years.

The practice is open from 8am until 8pm Monday to Friday, and 8am to 10am Saturday and Sundays. Clinical sessions with both GPs and nursing staff operated during the opening hours. These included clinics for cardio vascular disease (CVD), asthma, chronic obstructive pulmonary disease (COPD), diabetes, contraception, smoking cessation, minor illness, phlebotomy (blood taking), childhood immunisation and holiday vaccinations.

The practice has opted out of providing GP out of hour’s services. Patients calling the practice outside practice working hours are advised by the answerphone message to contact the 111 non-emergency services. Patients requiring urgent treatment are advised to contact the out of hour’s service provided by Prime Care.

Updated 8 August 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at North Chelmsford Healthcare Centre on 27 June 2017. Overall, the practice is rated as good.

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

• Staff members knew how to raise concerns, and report safety incidents.We saw these were reviewed, analysed, and monitored to avoid re-occurrences.
• Safety information was appropriately recorded; learning was identified and shared with all staff.
• The infection control policy met current guidance and audits had been undertaken to review, analyse and monitor effectiveness.
• Clinical audits were undertaken and we saw completed cycles enabling improvements to be measured.
• Risks to patients and staff had been assessed, documented and acted on appropriately. These had not been reviewed by the practice to check for themes or trends.
• Staff assessed patient care in line with current evidence based guidance.
• Staff showed they had the skills, knowledge, and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity, respect, and involved in their care and treatment decisions.
• Information about the practice services and how to complain was available at the reception desk and on the practice website in easy to understand formats. However, complaints were not monitored to understand any trends, or to avoid re-occurrences.
• The practice was aware of and complied with the requirements of the duty of candour when dealing with complaints and significant events in an open and honest manner.
• Patients said they were able to make an appointment with a GP and they received continuity of care. Patients also told us they had access to urgent on-the-day appointments.
• The practice facilities, and equipment was appropriate to treat patients and meet their needs.
• There was a clear leadership structure and in addition, staff members felt supported by the GPs and practice management team.

The areas where the provider should make improvements are:

• Risks to patients and staff should be reviewed regularly.
• Complaints should be reviewed to understand any trends, and avoid re-occurrences.
• Improve the identification of patients who are carers and provide them with support and guidance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 8 August 2017

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

• Nursing staff and GPs had lead roles in chronic disease management
• Patients at risk of hospital admission were identified as a priority. Personalised care plans ensured continuity of care.
• Diabetic quality data from 2015 to 2016 showed the practice averages were higher than local and national practices at 87%.

Other services provided by the practice for this population group were:

• Longer appointments and home visits when needed.
• People with long-term conditions were provided a named practice GP and a structured annual review to check their needs were met.
• The named GP worked with relevant health and social care professionals to deliver a multidisciplinary package of care, to reduce the need for hospital visits.
• Practice prescribers used clinical templates designed to ensure patients received blood tests and diagnostic checks required, before repeat prescriptions were given to patients.

Updated 8 August 2017

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

• There were systems in place to identify and follow up children living in disadvantaged circumstances or at risk, for example, those who had a high number of A&E attendances.
• Immunisation rates were higher than local and national practices, for all standard childhood immunisations.
• A range of contraception services was available.
• Cervical screening data showed the practice was comparable with other local and national practices.
• Appointments were available outside of school hours and college hours, and the premises were suitable for children and babies.
• On-line appointments were available for both advanced and on the day appointments.

Updated 8 August 2017

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

• The practice offered personalised care to meet the needs of older people in its population.
• The practice offered home visits and urgent appointments to those that needed them.
• All older people had a named GP.
• Palliative care meetings every six to eight weeks were used to understand and discuss patients identified as frail and at risk of deteriorating health.
• There was a high uptake for shingles and flu vaccinations due to active practice campaigning.
• Senior health checks were offered, on an ad hoc basis to maximise their uptake

Updated 8 August 2017

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

• The needs of the working age population, those recently retired and students had been identified, and the practice had adjusted the services offered.
• The practice offered appointments from 8am until 8pm each week day and from 8am until 10am on Saturdays and Sundays. These ensured working patients could attend the practice outside their working hours.
• They offered online services to book appointments, request repeat prescriptions, and receive text alert reminders for appointments.
• A full range of health promotion and screening was available at the practice that reflected the needs of this age group.

Updated 8 August 2017

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

• 95% of people diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months; this was 10% higher than local and national practices.
• The practice regularly worked with multi-disciplinary teams to support patients experiencing poor mental health, and including those with dementia.
• Staff members had received training to help safeguard adults and children from abuse. They were familiar with the details of the Mental Capacity Act.
• The staff had received guidance to direct patients that needed mental health support appropriately.
• The practice had told and supported patients experiencing poor mental health how to access various support groups and voluntary organisations.
• The practice followed up patients who had attended accident and emergency that may have been experiencing poor mental health.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 8 August 2017

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

• The practice recognised patients living in vulnerable circumstances including, homeless people, travellers and those with a learning disability.
• The practice offered longer or double appointments for patients with a learning disability. They had recognised 10 people with a learning disability, each of them had been offered a health review.
• The practice clinical members of staff worked with other health care professionals in the case management of vulnerable patients. They worked very closely with the local care home to provide, treatment planning, and home visits when needed.
• They provided information to vulnerable patients about how to access various support groups and voluntary organisations.
• Staff members knew how to recognise the signs of abuse and were aware of their responsibilities concerning the sharing of information regarding safeguarding concerns.
• The practice safeguarding policy set out the details to contact relevant local agencies during normal working, and out of hours.
• All staff members had undergone safeguarding training of vulnerable adults and children.
• The GP safeguarding lead at the practice attended forums when possible.