Archived: St Marks Hospital Primary Care Centre

Updated 18 August 2017

East Berkshire Primary Care Out Of Hours Services Limited is a not-for-profit social enterprise that provides urgent medical care and advice out-of-hours (OOH) for approximately 400,000 patients in Berkshire, 30,000 in South Buckinghamshire and 250,000 in Richmond and Twickenham from its operational headquarters in Bracknell.

St Marks Hospital Primary Care Centre is one of the registered locations for the OOH GP service provided by East Berkshire Primary Care Out Of Hours Services Limited.

The full address for this location is:

• St Marks Hospital Primary Care Centre, St Marks Hospital, St Marks Road , Maidenhead, Berkshire, SL6 6DU.

The administrative base and headquarters for East Berkshire Primary Care Out Of Hours Services Limited is located at Abbey House, Bracknell in Berkshire. St Marks Hospital Primary Care Centre is situated in space rented from the Berkshire Healthcare Foundation Trust and the facilities are managed by the respective organisation.

The service is contracted by the NHS clinical commissioning groups across Berkshire and provides OOH primary medical services to registered patients and those requiring immediately necessary treatment in Maidenhead, Berkshire and the surrounding area when GP practices are closed. This includes overnight, during weekends, bank holidays and when GP practices are closed for training. Most patients access the out of hour’s service via the NHS 111 telephone service. Patients may be seen by a clinician, receive a telephone consultation or a home visit, depending on their needs. Occasionally patients access the service as a walk-in patient.

The provider also manages an extended hour’s service at the St Marks Hospital and King Edward Hospital locations, this extended hours service is called ‘GP Hub’. GP Hub was designed to stimulate and test innovative ways of providing primary care services in order to meet the changing lifestyle and needs of patients by enhancing the accessibility of GP services.

The GP Hub service is open Monday to Friday between 6.30pm and 9.30pm, Saturday between 9am and 1pm, and Sunday between 11am and 2pm. All GP and nurse appointments are directly pre-booked by the GP practice that is part of Windsor, Ascot and Maidenhead Clinical Commissioning Group.

The health of people in Maidenhead is better when compared with the national averages. For example, 47% of people within Maidenhead have a long-standing health condition, lower when compared to the national average which is 54%. The higher percentage of people with a long-standing health condition could mean increased demand for GP services including OOH services. The age distribution of the population of Maidenhead is largely similar to the national averages. Life expectancy for both men and women is similar when compared with the national average.

Updated 18 August 2017

Letter from the Chief Inspector of General Practice

Our previous comprehensive inspection at East Berkshire Primary Care Out of Hours Services Limited – St Marks Hospital Primary Care Centre on 5 October 2016 found a breach of regulations relating to the safe and well-led delivery of services. The overall rating for the service was requires improvement. Specifically, we found the service to require improvement for the provision of safe and well led services. The service was rated good for providing effective, caring and responsive services. The full comprehensive report on the October 2016 inspection can be found by selecting the ‘all reports’ link for East Berkshire Primary Care Out of Hours Services Limited on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 5 July 2017 to confirm that the service had carried out their plan to meet the legal requirements in relation to the breach in regulations that we identified in our previous inspection in October 2016. This report covers our findings in relation to those requirements and improvements made since our last inspection.

We found the service had made improvements since our last inspection. At our inspection on the 5 July 2017 we found the service was meeting the regulations that had previously been breached. We have amended the rating for the service to reflect these changes and improvements. East Berkshire Primary Care Out of Hours Services Limited – St Marks Hospital Primary Care Centre is now rated good for the provision of safe, effective, caring, responsive and well led services. Overall the service is now rated as good.

Our key findings were as follows:

• East Berkshire Primary Care Out of Hours Services had comprehensively reviewed the existing governance framework in place and embedded the current models of best practice across all of the services locations.

• The medicines management team had implemented new processes to ensure that the service actioned all patient safety alerts and MHRA (Medicines and Healthcare Products Regulatory Agency) alerts.

• The service reviewed the Controlled Drug Home Office licence requirements and contacted the Home Office for confirmation and to begin the registration process.

• There was now a designated person specifically to manage quality, ensure improvements were made and sustained. This included consideration of location specific clinical audits to review, monitor and improve outcomes for people accessing care and treatment at the different locations within the service.

• The service had reviewed the internal arrangements to respond to emergencies and major incidents. This review had led to the emergency grab bags positioned throughout the service with appropriately signage and awareness training for staff.
• There was a monitoring system to manage risks associated with cleanliness, infection control and consumables (medical equipment and medicines) across the service. Internal auditing (including premises and out of hours vehicles) infection control auditing and quality auditing was now bi-monthly and specific to each site. We saw there had been a complete review of the medical equipment and medicines held across the service.
• The service had reviewed and taken steps to improve signage across all five primary care centres to ensure patients visiting each site could access the services without delay.
• Arrangements to manage training had been strengthened. Specifically, we saw all staff undertaking chaperoning duties, including the drivers of out of hours vehicles, had received appropriate chaperone training. Furthermore, as part of the review of training arrangements a member of staff had been appointed to monitor all training arrangements within the service.
• Information for patients about the complaints procedure was clearly on display and carried in vehicles for patients receiving care and treatment in their place of residence.
• There was an appraisal programme and all staff had received an annual appraisal within the last 12 months.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice