Integrated Care Centre Violet Melchett Centre

Updated 29 August 2019

Violet Melchett Centre Integrated Care Centre (GP Hub) operates from Violet Melchett Clinic, 30 Flood Walk, London, SW3 5RR and has access to two consultation rooms. The service is commissioned to provide GP and nurse pre-booked extended access appointments for the assessment and treatment of adults and children. This includes routine GP and nurse appointments, including cervical screening and childhood immunisation. The service does not undertake chronic disease management, repeat prescribing, referral to secondary care or arrange blood tests or radiology.

The service is one of the two GP hubs commissioned by NHS West London Clinical Commissioning Group (CCG) and provided by the West London GP Federation known as London Medical Associates (LMA). The federation was established in 2008. The LMA board is made up of five local GPs, two practice managers and a managing director. In addition, there is a clinical director, who is also a local GP but not an LMA board member.

The service serves a patient population of 250,000 registered at 42 GP practices, within five primary care networks, in the Kensington and Chelsea, Queen’s Park and Paddington areas. The second GP hub is located at St Charles Centre for Health and Wellbeing Integrated Care Centre, St Charles Hospital, Exmoor Street, London W10 6DZ

The service at this location is open from 6:30pm to 9pm on weekdays, from 8am to 4pm on Saturdays and from 8am to 2pm on Sundays. The service provides one GP at each session, one nurse on Tuesday, Wednesday, Thursday, Saturday and Sunday and two receptionists at each session.

The provider has centralised governance across both sites which are co-ordinated by the clinical director, GP leads, nurse lead, general manager and hub manager. This is overseen by a board of directors and a managing director. On the day of the inspection we met with the clinical director, lead GP for the location, the hub manager, general manager, a sessional GP, a locum nurse and two receptionists.

The provider is registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures and treatment of disease, disorder or injury.

Updated 29 August 2019

This service is rated as Good overall.

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Violet Melchett Centre Integrated Care Centre (GP Hub) on 26 June 2019 as part of our inspection programme. At this inspection we found:

• There were systems in place to safeguard children and vulnerable adults from abuse and staff we spoke with knew how to identify and report safeguarding concerns. All staff had been trained to a level appropriate to their role.
• There was an open and transparent approach to safety and systems were in place for recording, reporting and sharing learning from significant events.
• The service reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
• There was a programme of quality improvement including clinical audit which had a positive impact on quality of care and outcomes for patients.
• Staff had the skills, knowledge and experience to deliver effective care.
• Staff involved and treated people with compassion, kindness, dignity and respect.
• The service took complaints and concerns seriously to improve the quality of care.
• Leaders demonstrated they had the capacity and skills to deliver high-quality, sustainable care.
• The provider engaged with patients and staff to improve the service.
• The provider was aware of the duty of candour and examples we reviewed showed the service complied with these requirements.
• There was a focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Review current Public Health England (PHE) guidance in relation to immunisation status for staff in direct patient contact.
• Review guidance and training for non-clinical staff in relation to fridge temperature monitoring and recording in line with best practice.
• Review staff understanding of the term duty of candour.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care