Litcham Health Centre

Updated 9 January 2020

• The name of the registered provider is Litcham Health Centre.
• The address of the location is Manor Drive, Litcham, Kings Lynn, Norfolk, PE32 2NW.
• The practice is registered to provide the regulated activities of diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures and treatment of disease, disorder or injury.
• Litcham Health Centre holds a General Medical Services contract and provides services to approximately 3,500 patients in the Norfolk Clinical Commissioning Group (CCG) area.
• The practice has two GP partners (one female and one male) and two salaried GPs. The practice also employs three practice nurses, two healthcare assistants, three community healthcare assistants, four dispensers, and a team of receptionists and administration staff who support the practice manager, deputy practice manager and reception manager.
• The practice is able to offer dispensing services to eligible patients on the practice list. We visited the dispensary as part of this inspection.
• The practice is open between 8am and 6.30pm on a Monday and Friday, between 7.30am and 6.30pm Tuesday and Thursday and between 7.30am and 5.30pm on a Wednesday.
• Appointments are available to book in advance with urgent appointments available on the same day for people that need them.
• When the practice is closed patients can also access care and treatment via the NHS111 service.
• We reviewed the most recent data available to us from Public Health England which showed the practice has a broadly similar practice demography to the local and national average. The practice population has a deprivation score of six, where one indicates the most deprivation and ten indicates the least deprivation. Life expectancy for patients at the practice is 79 years for males and 83 years for females.

Updated 9 January 2020

We carried out an announced focussed inspection at Litcham Health Centre on 14 November 2019 to follow up on breaches of regulations identified at a previous inspection in November 2018.

At the last inspection in November 2018 we rated the practice as requires improvement for providing safe services because:

• The practice did not have appropriate systems in place for the safe management of medicines.
• The practice did not have effective infection prevention and control systems and processes in place.

At this inspection we rated the practice as Good for providing safe services because sufficient improvements had been made since our last inspection including:

• Introducing a system of more frequent checks for emergency medicines and equipment and a protocol for managing out of date medicines.
• Introducing a new standard operating procedure for managing the cleaning of equipment, supported by cleaning schedules and regular reviews.

We also reviewed additional areas identified in our previous inspection where the practice could improve and found:

• The practice had reviewed and improved their identification and recording of patients who were carers through patient registration forms and clinical reviews, for example identifying carers of patients with dementia. The practice had identified 37 patients who were carers, representing 1% of the practice population. The practice had a dedicated member of staff who identified and provided support for carers including information about local support services.
• The practice had carried out a number of antibiotic prescribing audits and had identified areas for improvement, however action plans and further audit cycles were required to demonstrate improved antibiotic prescribing rates. 
• The practice had provided training for non-clinical staff in identifying deteriorating or acutely unwell patient’s suffering from potential illnesses such as sepsis. Reception staff we spoke with confirmed appropriate signs and symptoms they would look for and appropriate systems for raising concerns with a clinician.
• The practice had carried out a detailed risk assessment and had put in place mitigating actions to reduce or remove identified risks for each of the remote collection points used for medicines dispensed by the practice. Actions included improving the recording of who was collecting medicines and making regular visits to each site to assess security risks.  
• The practice had reviewed how standard operating procedures (SOP) were implemented in the dispensary and demonstrated how staff had signed up to work within each SOP and how their compliance was monitored, including through call audits.
• The practice had reviewed their system for ensuring staff received regular appraisals and since the last inspection had scheduled all staff for an appraisal. Staff we spoke with confirmed they had had an appraisal and valued the experience as an opportunity to discuss performance, development opportunities and learning needs. Staff also used the opportunity to discuss concerns and issues where required, however felt they could approach management at any time to discuss problems.

Whilst we found no breaches of regulations, the provider should:

• Continue to review and improve antibiotic prescribing rates.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Updated 16 January 2019

Updated 16 January 2019

Updated 16 January 2019

Updated 16 January 2019

Updated 16 January 2019

Updated 16 January 2019