Medvivo

Updated 15 April 2019

Medvivo is the registered location for services provided by Medvivo Group Limited and is registered to provide services from Fox Talbot House, Greenways Business Park, Bellinger Close

Chippenham, Wiltshire SN15 1BN The service covers a population of approximately 900,000 people across the counties of Wiltshire, Bath and North East Somerset and Swindon. The service is a large employer, with between 500 and 600 staff and 147 sessional GPs. Deprivation across the area overall is lower than the national average and it has relatively low numbers of patients from different cultural backgrounds. Medvivo provides a number of services for patients in this area which include:

• NHS 111 service, delivered through a formal subcontract arrangement with another provider. (NHS 111is a telephone based service where people are assessed, given advice and directed to a local service that most appropriately meets their needs).
• Clinical Assessment Service in which healthcare professionals determine the most appropriate pathway that will best meet patient needs.
• The Access to Care service which provides a single point of access, via a direct dial telephone number for health professionals and identified patients. This provides a single point of access is to act as a referral mechanism into both the integrated community teams and the community hospitals in Wiltshire.
• Urgent Care and at home response team (UC@H) provides rapid health and social care response for people experiencing a crisis in their own home in Wiltshire.
• Urgent Care Clinic (SUCCESS) and Children’s & Young Person’s clinics (CYPC) in Swindon. These services provide additional capacity for urgent demand for patients accessing primary care within this area.
• GP resilience support, providing in hours support for practices in Wiltshire where there is a need.
• GP Out of Hours (OOH) services across BaNES, Swindon and Wiltshire where care is delivered from nine sites across the area:

• Chippenham Community Hospital, Rowden Hill, Chippenham, Wiltshire, SN15 2AJ (open 6.30pm until 8am Monday to Friday and 24 hours over weekends and bank holidays)

• Salisbury Hospital NHS Foundation Trust, Odstock Road, Salisbury, Wiltshire SP2 8BJ Emergency Department (open 6.30pm until 8am Monday to Friday and 24 hours over weekends and bank holidays).

• Trowbridge Community Hospital, Adcroft Street, Trowbridge, BA14 8PH (open 6.30pm until 8am Monday to Friday and 24 hours over weekends and bank holidays)

• Savernake Community Hospital: Savernake, Marlborough, SN8 3HL. open from 7.30pm until midnight weekdays and 8am until midnight weekends and Bank Holidays)

• Warminster Community Hospital, The Avenue, Warminster, BA12 8QS (open 7.30pm to midnight weekdays and 9am to 11pm at weekends and Bank Holidays).

• Devizes Community Hospital, Family Health Centre, Couch Lane Devizes, SN10 1EF (open 12pm to 6pm Saturdays only)

• Royal United Hospital, Coombe Park, Bath BA1 3NG ( open 6.30pm – 8am weekdays and 24hrs weekends and bank holidays.

• Paulton Minor Injuries Unit, Salisbury Road, Bristol BS39 7sb ( open weekends only 8am – midnight)

• Swindon NHS Health Centre, 1 Islington Street, Swindon, SN1 2DQ ( open 8am – 8pm daily)

• Moredon Medical centre, Moredon Road, Swindon SN2 2JG (open 8am – 8pm daily

We visited the sites at Royal United Hospital, Trowbridge, Chippenham, Savernake and Swindon (this included the OOH service and both the in hours SUCCESS and CPYC clinics) as part of this inspection.

Medvivo Group Limited is registered to provide the following regulated activies:

• Treatment Disease, disorder and injury
• Personal Care
• Transport services, triage and medical advice provided remotely

Updated 15 April 2019

This service is rated as Outstanding overall. (Previous inspection February 2017 – Outstanding)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Outstanding

Are services responsive? – Outstanding

Are services well-led? – Outstanding

We carried out an announced comprehensive inspection at Medvivo on 22-24 January as part of our inspection programme.

At this inspection we found:

• The service had good systems to manage risk so that safety incidents were less likely to happen. When they did happen, there was a focus on openness, transparency and the service learned from them and improved their processes.
• The service routinely reviewed the effectiveness and appropriateness of the care it provided. Evidence base guideline updates were regularly cascaded to staff. However we found in the sample of medical records reviewed that documentation was not always in line current best practice and guidance. Staff involved and treated people with compassion, kindness, dignity and respect. Patients were valued as individuals and were empowered to have a voice in their own care.
• Patients could access care and treatment from the service within an appropriate timescale for their needs. Care was person centred and services were tailored and delivered to meet the needs of an individual in a way that ensured flexibility and choice.
• There was a strong focus on continuous learning and improvement at all levels of the organisation and the culture ensured all staff were engaged to deliver high quality person centred care.

We saw several areas of outstanding practice:

• The provider worked collaboratively with external stakeholders on a range of initiatives to improve access to care and patient experience for those who were vulnerable, had a disability or were from a minority group. An example of this was use of the Streetlink homelessness App and delivering care for refugees being repatriated to the UK.
• There were innovative approaches to providing integrated patient-centred care. For example, the provider delivered an Urgent Care @Home service. The service ensured an integrated rapid health and social care response for service users in a health or social care crisis in their own home to avoid inappropriate admissions and expedite hospital discharges. This had not only improved patient outcomes but it has also supported the whole system in terms of increased capacity and financial savings.
• There was a strong emphasis on staff wellbeing. The interventions initiated by the provider had led to a decrease in turnover of over 6% in the last 12 months. Examples of initiatives taken were a Health and Wellbeing Charter developed with staff, the introduction of Mental Health First Aiders, resilience workshops and self-awareness campaigns.

The area where the provider should make improvements:

• Improve and monitor documentation of consultations, to ensure they are consistently in line with best practice and current guidance.

Dr Rosie Benneyworth BS BM BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care