Earnswood Medical Centre

Updated 8 August 2017

Earnswood Medical Centre provides primary medical services to approximately 15,130 patients in the catchment area of Crewe and surrounding rural areas. The practice is situated at Eagle Bridge Health And Well Being Centre, Dunwoody Way, Crewe. Services are provided from a purpose built building on the outskirts of Crewe town centre. Co-located with the practice are a number of other services, including podiatry, dentistry, physiotherapy, pharmacy and help groups.

The practice is managed by five GP partners. In addition there are two salaried GPs and a locum GP. There is a team of nursing staff including a nurse manager, five practice nurses and a healthcare assistant. There are both male and female clinical staff. They are supported by a team of management, reception and administrative staff. The practice is a training practice and there was a GP registrar at the practice at the time of the inspection.

Earnswood Medical Centre is open from 8am to 6.30pm Monday to Friday. Extended hours are provided Tuesday morning from 7.30am and every second Saturday from 8am -12pm. Patients requiring a GP outside of normal working hours are advised to contact the GP out of hours service, by calling 111. Patient facilities are located on one level and there is a car park.

The practice has a General Medical Service (GMS) contract. The practice offers a range of enhanced services including avoiding unplanned hospital admissions, minor surgery, timely diagnosis of dementia and flu and shingles vaccinations.

We undertook a comprehensive inspection of Earnswood Medical Centre on 13 October 2015. The practice was rated as good overall. However a requirement notice was made as improvements were needed to patient access.

Updated 8 August 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Earnswood Medical Centre on 13 October 2015. The overall rating for the practice was good however a requirement notice was made as improvements were needed to patient access. The full comprehensive report on the October 2015 inspection can be found by selecting the ‘all reports’ link for Earnswood Medical Centre on our website at www.cqc.org.uk.

This inspection was undertaken on 27 June 2017 and was an announced comprehensive inspection.

Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There were systems in place to reduce risks to patient safety, for example, equipment checks were carried out, there were systems to protect patients from the risks associated with insufficient staffing levels and to prevent the spread of infection.

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Staff were aware of procedures for safeguarding patients from the risk of abuse.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.

• Staff felt supported. They had access to training and development opportunities appropriate to their roles.

• Patients said they were treated with compassion, dignity and respect. We saw staff treated patients with kindness and respect.

• Services were planned and delivered to take into account the needs of different patient groups.

• Access to the service was monitored to ensure it met the needs of patients.

• There was a system in place to manage complaints.

• There were systems in place to monitor and improve quality and identify risk.

The areas where the provider should make improvements are:

• The system for sharing learning from complaints, significant events, MHRA drug alerts and audits should be reviewed to ensure that there is a clear method of sharing this information with colleagues unable to attend or who do not participate in these meetings.

• Significant events should where appropriate be reported externally so that learning can be shared across practices within the same Clinical Commissioning Group (CCG) or nationally.

• Staff recruitment records should contain evidence of health information.
• The salaried GPs should have an in-house appraisal in addition to the external appraisal process.
• The practice should take steps where possible to ensure the new telephone system is installed without further delay.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 8 August 2017

The practice is rated as good for the care of people with long-term conditions. The practice held information about the prevalence of specific long term conditions within its patient population such as diabetes, chronic obstructive pulmonary disease (COPD), cardio vascular disease and hypertension. This information was reflected in the services provided, for example, reviews of conditions and treatment, screening programmes and vaccination programmes. The practice had a system in place to ensure patients were recalled for reviews of their long term conditions. The nurse manager was able to prescribe and had also received diagnostics training which was beneficial for patients with respiratory issues. The nurse manager had support from a GP in undertaking this role.  The practice aimed to ensure that patients were able to have their long term conditions reviewed in one visit to reduce the need for multiple appointments. The practice worked closely with a dedicated pharmacy technician who overviewed prescribing. The practice worked with other agencies and health providers to provide support and access to specialist help when needed.

Updated 8 August 2017

The practice is rated as good for the care of families, children and young people. Priority was given to young children who needed to see the GP and appointments were available outside of school hours. A One Stop Shop clinic was provided to new mothers who could attend for their babies six week check, postnatal care and family planning advice. Immunisation clinics were held each day at different times to provide flexibility. Family planning and sexual health services were also provided. The GPs liaised with other health care professionals, such as health visitors to ensure the needs of vulnerable children were addressed. A breast feeding room, accessible toilets and baby change facilities were provided.

Updated 8 August 2017

The practice is rated as good for the care of older people. The practice kept registers of patients’ health conditions and used this information to plan reviews of health care and to offer services such as vaccinations for flu and shingles. The practice had the largest number of older patients in care homes in the area. GPs visited one local nursing home three times a week and another nursing home twice a week. V isits were carried out by the same clinicians to provide continuity. During these visits patients’ needs were assessed, care plans were developed and a review of long term conditions took place. The GPs could be contacted outside of these visits during surgery hours and the GPs also provided personal contact details to senior care home staff so that they could be contacted for advice and guidance outside surgery hours. We met with two managers from a care home supported by the practice. They told us that the service provided by the practice was caring and responsive and had helped to reduce the number of hospital admissions. The practice worked with other agencies and health providers to provide support and access specialist help when needed. Multi-disciplinary meetings were held to discuss and plan for the care of frail and elderly patients.

Updated 8 August 2017

The practice is rated as good for the care of working-age people (including those recently retired and students). The practice appointment system and opening times provided flexibility to working patients and those in full time education. The practice was open from 8am to 6.30pm Monday to Friday. Extended hours were provided Tuesday morning from 7.30am and every second Saturday from 8am -12pm. The practice offered GP triage so a patient could speak to a GP whilst at work. Patients could book routine appointments in person, via the telephone and on-line. Repeat prescriptions could be ordered on-line, by attending the practice and there was a dedicated answerphone number for prescription ordering. Telephone consultations were also offered. Mobile phone texts were made to remind patients about appointments and reduce missed appointments and for some test results. The practice offered health promotion and screening that reflected the needs of this population group such as cervical screening, NHS health checks, contraceptive services, smoking cessation advice and family planning services.

Updated 8 August 2017

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). GPs worked with specialist services to review care and to ensure patients received the support they needed. The practice maintained a register of patients who experienced poor mental health. The register supported clinical staff to offer patients experiencing poor mental health, including dementia, an annual health check and a medication review. Care plans were developed to support patients and patient records were coded with carers’ details to enable them to attend with the patient where appropriate. Accident and emergency attendance was monitored for patients identified as a high risk. Longer appointment times and appointments outside of ordinary working times were offered to support patients who may have difficulty in attending a busy practice. The practice worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. The practice referred patients to appropriate services such as memory clinics, psychiatry and counselling services. Clinicians had attended training for mental health and dementia and the staff team had received training in dementia awareness to assist them in identifying patients who may need extra support.  

Updated 8 August 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable. Patients’ electronic records contained alerts for staff regarding patients requiring additional assistance. For example, if a patient had a learning disability to enable appropriate support to be provided. The practice worked with health and social care services to support the needs of vulnerable patients. Services for carers were publicised and a record was kept of carers to ensure they had access to appropriate services. A member of staff was the carer’s link. The practice referred patients to local health and social care services for support, such as drug and alcohol services. Staff had received safeguarding training relevant to their role and they understood their responsibilities in this area. Staff had recently received training on supporting patients who were experiencing domestic violence.  Patients were informed about how to access various support groups and voluntary organisations.