Background to this inspection
Updated
9 August 2019
The Boulevard Medical Centre provides primary medical services to approximately 1,900 patients in the Beechdale area of Nottingham. The practice is located at 635 Western Boulevard, Nottingham, Nottinghamshire, NG8 5GS.
The provider is registered for the provision of the following regulated activities: Diagnostic and screening procedures, Family planning, Maternity and midwifery services and Surgical procedures, Treatment of disease, disorder or injury.
The Boulevard Medical Centre is part of the Beechdale Medical Group which has two further GP practices located within a close radius. Each practice holds a Primary Medical Services (PMS) contract with Nottingham City CCG and each has a separate patient list. Beechdale Medical Group is a partnership between a GP and an advanced nurse practitioner. Patients registered within any practice within the Beechdale Medical Group have access to appointments at all sites.
The Boulevard Medical Centre is situated in an area of high deprivation falling into the most deprived decile. Income deprivation affecting children and older people is above the local clinical commissioning group (CCG) and national averages.
The clinical staff comprises of locum GP cover, practice nurses and healthcare assistant. The clinical team is supported by a group business manager, a practice manager and a team of administration and reception staff. A number of staff work across the group.
The practice is open between 8am and 6.30pm Monday to Friday. Patients could access extended appointments at other practise within the Beechdale Medical Group or at GP+ which is a local federation who offers extended access.
When the practice is closed out-of-hours GP services are provided by Nottinghamshire Emergency Medicine Services (NEMS) which is accessed by telephoning the NHS 111 services.
Updated
9 August 2019
We carried out an unannounced focussed inspection at Boulevard Medical Centre on 27 June 2019 in response to concerns that we found at another practice which was part of the Beechdale Medical Group.
The practice had previously been inspected in June 2018 where it was rates as good overall.
We based our judgement of the quality of care at this service on a combination of:
- what we found when we inspected
- information from our ongoing monitoring of data about services and
- information from the provider, patients, the public and other organisations.
We have rated this practice as inadequate overall.
We rated the practice as inadequate for providing safe services because:
- The practice did not have clear systems and processes to assess, monitor and manage risks to patients safety.
- There was no clinical oversight of staff working at the practice.
- The premises were not fit for purpose and there was not effective infection prevention and control measures.
- Equipment and medicines were out of date and put patient’s safety at risk.
- There was limited monitoring of patient safety.
- Care and treatment were not always delivered in line with national guidance.
- The practice was unable to show that staff had the skills, knowledge and experience to carry out their roles.
We rated the practice as inadequate for providing well-led services because:
- The practice was transitioning through a change in management and systems had not been embedded.
- Leaders could not show that they had the capacity and skills to deliver high quality, sustainable care.
- The practice culture did not effectively support high quality sustainable care.
- The overall governance arrangements were ineffective.
- The practice did not have clear and effective processes for managing risks, issues and performance.
- The practice did not always act on appropriate and accurate information.
As a result of these concerns, we took immediate action to impose urgent conditions remove the location on the registration. This means that regulated activities can no longer be carried out at The Boulevard Medical Centre.
I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.
The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.
Special measures will give people who use the service the reassurance that the care they get should improve.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care