Memorial Medical Centre

Updated 12 September 2017

Memorial Medical Centre is located near to the centre of Sittingbourne, Kent. The practice patient population is relatively evenly spread across all age groups. The practice is part of the NHS Swale Clinical Commissioning Group and has approximately 15,800 patients.

The area the practice serves is urban and has relatively low numbers of patients from different cultural backgrounds. The practice has more patients registered under the age of 14 years than the national average. The practice area is in the mid-range for deprivation nationally and has a slightly lower than average number of patients (2%) who are unemployed compared to the local average of 5%. The percentage of patients living with a living term chronic disease is 61% which is similar to the local average of 58%.

The practice is managed by four GP partners (one male and three female) and one nurse partner (female). The practice is supported by three salaried GPs (one female and two male) one GP locum, four practice nurses and two health care assistants (all female), one paramedic (male) and an administrative team led by the business manager. The practice is approved for training nursing students and qualified doctors.

The practice is open between 8am and 6.30pm Monday to Friday. Appointments are available between 9am and 11.10am every morning and 3pm to 5pm every afternoon.

Extended hours appointments are offered from 7am to 7.50am on Tuesday morning and 6pm until 7.50pm on a Monday evening. In addition to pre-bookable appointments that can be booked up to four weeks in advance, urgent appointments are available for patients that needed them. Telephone appointments are also available to book.

The practice has a General Medical Services (GMS) contract to deliver health care services.

Services are provided from:

Memorial Medical Centre

Bell Road,

Sittingbourne,

Kent, ME10 4XX

There are arrangements with other providers (Medway Doctors on Call Care.) via the NHS 111 system to deliver services to patients outside of the practice’s working hours.

Updated 12 September 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Memorial Medical Centre on the 19 January 2017. The overall rating for the practice was good. However, the practice was rated as requires improvement for providing safe services. The full comprehensive report on the January 2017 inspection can be found by selecting the ‘all reports’ link for Memorial Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 10 August 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• There were appropriate arrangements for identifying, recording and managing risks and implementing mitigating actions.
• The practice had an up to date fire risk assessment and carried out regular fire drills. There were designated fire marshals within the practice. There was a fire evacuation plan and the practice had identified how staff could support patients with mobility problems to vacate the premises.
• Emergency medicines were easily accessible to staff in a secure area of the practice and staff knew of their location.
• The practice had implemented an action plan to improve access to ensure that patients were able to book appointments that suited their needs. At our previous inspection 67% of patients were able to get an appointment to see or speak with someone the last time they tried. This has improved to 73% compared to the local average of 76% and the national average of 84%.
• The number of carers identified by the practice had increased from 68 at our last inspection in January to 132 (1% of the practice list). Written information was available to direct carers to the various avenues of support available to them. A member of staff acted as a carers’ champion to help ensure that the various services supporting carers were coordinated and effective.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 March 2017

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Nurses had undertaken diploma level training in the management of chronic disease and attended regular updates.
• The percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) was within target range, was 75% compared to a local average of 77% and a national average 78%.
• Patients who were at risk of developing diabetes were encouraged to engage with a local scheme to identify those at risk and promote a healthy lifestyle.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 22 March 2017

The practice is rated as good for the care of Families, children and young people.

• There were systems to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of accident and emergency (A&E) attendances. Immunisation rates were relatively high for all standard childhood immunisations.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• The percentage of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding 5 years (2015 to 2016) was 83% which was similar to the local and national average of 81%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 22 March 2017

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its patient population.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Updated 22 March 2017

The practice is rated as good for the care of Working age people (including those recently retired and students).

• The needs of the working age patient population, those recently retired and students had been identified and the practice had adjusted the services it offered to help ensure these were accessible, flexible and offered continuity of care.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.
• Uptake for bowel and breast cancer screening was higher than the averages achieved locally and nationally.

Updated 22 March 2017

The practice is rated as good for people experiencing poor mental health (including people with dementia)

• 94% of patients diagnosed with dementia that had their care reviewed in a face to face meeting in the last 12 months, which was higher than the local average of 83% and the national average of 84%.
• The percentage of patients with a serious mental health illness who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months was 95% which was similar to the local average of 93% and higher than the national average of 89%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice carried out advance care planning for patients with dementia.
• The practice provided medical services to a local rehabilitation unit, eight local nursing and residential homes and had a contract with the local CCG to provide care for a nursing home caring for patients with advanced dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 22 March 2017

The practice is rated as good for people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability.
• There were longer appointments available for patients with a learning disability. These appointments were at the beginning of the surgery to alleviate possible anxieties of waiting in a crowded area. The practice had developed a comprehensive review template to help ensure consistency and delivery of guidelines standard of care. All patients with a learning disability received a health action plan following the consultation to support patients and carers. Pictorial formats were used where appropriate.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.