Norwich Practices Health Centre and Walk in Centre

Updated 13 May 2022

Norwich Practices Health Centre and Walk in Centre is located in the heart of the City of Norwich. The provider is Norwich Practices Ltd.

The practice provides primary medical services to a diverse patient population that are generally younger than average.

The walk-in centre is not registered with CQC separately from the GP practice, but we only inspected the walk-in centre. The walk-in centre service is commissioned by NHS England.

The walk-in centre is open 365 days a year from 7am to 9pm. Patients do not have to be registered with this GP practice or any other practice and are free to walk-in without an appointment. The service is open to adults and children.

The centre treats minor illness and injury and deals with sexual health matters, contraception, blood pressure checks and holds a phlebotomy clinic from 8am to 12.30pm Monday to Friday.

The service has approximately 6,000 patient contacts a month (200 daily), which is back to pre-pandemic levels, there having been a decline during 2021

Updated 13 May 2022

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Norwich Practices Health Centre and Walk in Centre on 4 August 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the August 2016 inspection can be found by selecting the ‘all reports’ link for Norwich Practices Health Centre and Walk in Centre on our website at www.cqc.org.uk.

This inspection was an announced comprehensive inspection undertaken on 9 October 2017. Overall the practice is now rated as good.

Our key findings were as follows:

• The practice demonstrated improved systems to assess, monitor, and improve the quality and safety of the services provided in the carrying on of regulated activities (including the quality experience of service users in receiving those services).
• The practice had improved the systems and process to ensure that staff were safely employed. Staff training was prioritised and accurate records kept.
• There were new systems and processes in place to ensure that the coding of medical records and the recall of patients ensured patients received appropriate follow ups; for example, those for long term conditions. The practice had produced a guide for any locum GPs who may work at the practice.
• Patients with learning disabilities had received health reviews in a timely manner.
• The practice had reviewed the national patient survey data published in July 2017, and this showed significant improvements from the data of July 2016.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. The practice were able to evidence significant events were recorded and discussed at practice meetings.
• Risks to patients were assessed and well managed. Comprehensive risk registers were held and clinical and non-clinical audits were carried out.
• Information about services and how to complain was available to patients and the practice recorded verbal and written complaints.
• Patients said they found it relatively easy to make an appointment with a named GP.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice offered a walk in phlebotomy service and had on site sessions provided by the community mental health nurses.
• Practice staff felt supported by management and the GPs. The practice proactively sought feedback from staff and used the patient participation group survey for feedback from patients.
• The provider was aware of and complied with the requirements of the duty of candour.
• Patients said they were treated with compassion, dignity, and respect and they were involved in their care and decisions about their treatment.
• The practice had implemented systems to pro-actively identify patients who were carers to ensure they received appropriate support.

We saw areas of outstanding service

• The practice looked after patients in two local care homes. One nurse practitioner with a prescribing qualification and a health care assistant (HCA), both directly employed by the practice provided on site healthcare at one of these homes where 120 patients; this service was provided five days a week. These staff members were based at the care home and available throughout the day to undertake both acute and proactive health care. The nurse and HCA had undertaken the wound care of patients which would have normally been dealt with by the community nurses. Due to the more frequent and timely service, the patients wounds had healed more quickly and they had been discharged from the caseload. Data shared with us from the CCG showed a significant reduction in the community nursing team visits. The CCG also shared data with us that showed the percentage of patients with no unplanned admission or attendance at A+E for the care home was 66% compared to 51% for other care homes in Norwich. The HCA attended the weekly Forget-me-Not session at the home, this session is dedicated to those patients living with dementia in the home. We saw copies of two leaflets written and designed by the nurse practitioner which gave patients, family, friends, and carers detailed, easy to understand information on comfort care for people approaching the end of life and for people with advance dementia approaching the end of life. A comprehensive log was kept of all the patients in the care homes to support care. This log detailed the diagnosis, review dates including date the patient was last seen by a GP, anticipated needs of the patients preferred place of care and the fragility status of the patient. This system was supported by the CCG who intended to use this model of care more widely.
• The practice had managed the local Special Allocation Scheme (SAS) patient group since October 2011. This scheme was for patients who were not able to be registered with a GP practice. Patients registered on this scheme had access to a nurse practitioner for advice Monday to Friday from 8.30am until 6.30pm and had pre booked appointments with a GP twice a week. Statistics shared with us from the chair of the SAS showed that the total number of patients on the scheme to date was 76. Of these, 11 had moved to another region and five had transferred to the provider for health services for people who are homeless. Of the remaining 60 patients, 40 (67%) had been registered at a surgery of their choice and none of these had returned to the SAS. The practice told us these positive results were achieved through continuity of care, dedicated team work, and ensuring care plans were agreed with the patient and adhered to. In some cases, the practice undertook joint working with the patient’s new practice to ensure safe handover of care. We saw evidence of detailed discussions by the practice team in relation to these patients who were at significant risk and potentially could be marginalised. These included discussions in relation to those that were experiencing poor mental health, those who had recently left prison, and those were at risk of self-harming.

The areas where the provider should make improvement are:

• Continue to explore ways to encourage patients to attend appointments and engage with national screening programmes for cervical breast and bowel cancer.
• Continue to monitor the GP patient survey and feedback and respond to the results as appropriate.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice