Primary Care Access Hub - Meir Primary Care Centre

Updated 24 April 2018

Primary Care Access Hub-Meir Primary Care Centre-is registered with the Care Quality Commission to provide an out-of-hours service. The service is managed by North Staffordshire GP Federation (NSGPFed), a not for profit private limited company which was established in 2015, following the demise of the previous GP Federation. The service currently supports 76 GP practices across the Stoke-on-Trent and North Staffordshire area covering 500,000 patients. Members are independent practices who are working together to represent primary care as a provider in the development of services and new models of service provision and has a board of nine directors, including two clinical directors. Their aim is to provide continuing care for local patients, and to reduce A&E attendance by patients for whom primary care services are more appropriate. More information about the provider is available on their website at www.nsgpfed.org.uk

The Primary Care Access Hub (PCAH) is a service commissioned by the North Staffordshire and Stoke-on-Trent Clinical Commissioning group (CCG) and provides an out -of-hour’s general medical service every Saturday and a number of bank holidays from 8am till 4pm. The service is run from the second floor of Meir Primary Care Centre, Stoke on Trent, Staffordshire ST3 6AB, which is a large purpose built primary care centre providing a range of services. The Primary Care Access Hub provides a GP led service from Willow Bank Surgery that is also open on a Saturday from 8am till 4 pm for its registered patients. The PCAH utilises space within the surgery including consultation rooms, the waiting area and reception services provided by the surgery. All appointments are booked directly through the NHS 111 service who determine whether the patient is suitable to be seen by the GPs at the PCAH. Each appointment is 15 minutes and available between 8:30am until 12 noon and between 12.15pm to 3.45pm. The service is staffed by two GPs in the morning and two GPs in the afternoon, providing a total of 56 appointments.

The provider has in excess of 40 GPs working for them on a sessional basis that all work locally in Stoke-on-Trent or North Staffordshire GP practices. The management team consists of the manager and deputy manager of Hanley Primary Care Access Hub, which is also run by the provider, with operations overseen by the provider’s business manager and the board of directors. GPs have access to patients’ clinical records and provide assessment, treatment, order tests in addition to prescribing and making urgent referrals where appropriate. The outcome of each consultation is sent electronically to the patient’s registered practice for the following working day so that the patient’s usual registered GP practice is kept fully informed of the outcome of the consultation in a timely manner.

Updated 24 April 2018

This service is rated as Good overall.

The key questions 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 Primary Care Access Hub - Meir Primary Care Centre on 10 March 2018 as part of our inspection programme.

Our key findings were as follows:

• There was an open and transparent approach to safety and a system in place for recording, reporting and learning from significant events. When incidents did happen, there were arrangements in place to ensure learning was shared to improve processes.
• There were systems in place to keep patients safe and safeguarded from abuse and for identifying, assessing and mitigating risks to the health and safety of patients. However, the oversight of safety checks needed strengthening.
• There was a system in place that enabled sessional GPs providing treatment to access patient electronic records. Written agreements were in place for sharing information with staff and external partners to enable them to deliver safe care and treatment.
• The service managed patients’ care and treatment in a timely and effective way.
• 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.
• Patients told us they felt listened and involved in their care and treatment and were treated with compassion, kindness, dignity and respect. They spoke highly of the care and treatment they had received and told us they would highly recommend the service.
• The service worked proactively with other organisations and providers to ensure patients had access to alternatives to hospital admission or urgent care services where appropriate, which improved the patient experience.
• The service sought feedback from staff and patients, which it acted on.
• There was a clear leadership structure and staff felt supported in their work. There was a strong focus on learning and improvement and a commitment to improve continuing care for local patients in addition to reducing demand on other parts of the healthcare system such as A&E services.
• The service only employed local GP partners and salaried GPs who were therefore familiar with all the local systems, referral pathways and prescribing formulary. The service had a comprehensive system for post consultation messaging to local GP practices with frequent examples of personalised follow up by a clinical director. For example, telephone calls were made to patients registered practice to confirm urgent referrals had been made or investigation requests actioned to ensure continuity of care.
• The service had a detailed and extensive customisation of directory of services with the local NHS 111 service to ensure only the patients that would benefit from this service were provided with an appointment.
• There was a detailed and systematic review of the quality of consultations undertaken by a clinical director providing evidence of individual feedback and learning.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvements are:

• Review policies to ensure they are specific to the service, inform practice and are dated to ensure they are reviewed and updated within an appropriate time frame and reflect latest guidance.

• Develop documented systems to gain assurances that safety checks on emergency medicines, equipment and health and safety checks are carried out and actioned at the premises where the service is delivered from.

• Review significant events to ensure they are recorded in line with policy.

• Review the complaint policy to ensure people who complain are advised of the escalation process and ensure complaints about clinical matters are considered and investigated as significant events.

• Review the system for receiving and acting on external safety alerts.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice