Elmwood Medical Centre

Updated 30 October 2023

Elmwood Medical Centre is located in Buxton in the Derbyshire High Peak area at:

7 Burlington Road

Buxton

Derbyshire

SK17 9AY

The provider is a partnership registered with the CQC to deliver the regulated activities; diagnostic and screening procedures, maternity and midwifery services, family planning, surgical procedures and treatment of disease, disorder or injury. The provider partnered with GoToDoc Limited (a not-for-profit private organisation) in April 2020 however, this did not result in the provider having to reregister with CQC.

The practice is situated within the Joined Up Care Derbyshire Integrated Care System (ICS) and delivers Personal Medical Services (PMS) to a patient population of approximately 6,599 people. This is part of a contract held with NHS England.

The practice is part of the High Peak and Buxton Primary Care Network (PCN), a wider network of 8 GP practices that work collaboratively to deliver primary care services.

Information published by the Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the 7th decile (7 out of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is predominantly white at 97.7% of the registered patients, with estimates of 0.9% Asian, 0.3% Black, 1% mixed and 0.1% other.

The age distribution of the practice population is comparable with local and national averages.

There are 2 salaried GPs and 3 long-term locum GPs, 2 locum advanced nurse practitioners and 2 practice nurses. The clinical staff are supported by 2 operations managers and a team of reception and administrative staff.

The practice is open between 8am to 6.30pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

Enhanced access is provided locally by High Peak and Buxton PCN, where late evening and weekend appointments are shared across all of the practices within the PCN throughout the week and provided by Derbyshire Health United (DHU) on Fridays and Saturdays. Out of hours services are provided by DHU.

Updated 30 October 2023

We carried out an announced comprehensive inspection at Elmwood Medical Centre on 18 and 21 September 2023. Overall, the practice is rated as Good. It is rated as good for providing safe, effective and well-led services. Due to assurances we received from our review of information, we carried forward the rating of good from our previous inspection in January 2023 for the key question caring. We rated the practice requires improvement for providing a responsive service.

Following our previous inspection on 27 January 2023, the practice was rated inadequate overall and for the key questions safe and well-led. We rated the key questions effective and responsive as requires improvement and caring as good. The practice was placed into special measures. We carried out an unrated inspection on 26 June 2023 to check that the breaches of regulation had been addressed and found that most of them had been.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Elmwood Medical Centre on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection to follow up on breaches of regulation and 3 best practice recommendations from our previous inspections in January and June 2023. We inspected the key questions safe, effective, responsive and well-led.

How we carried out the inspection.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Conducting staff interviews using video conferencing.
• Sending out staff questionnaires.
• Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A site visit.
• Interviews with a representative from the Patient Participation Group
• Interviews with representatives from 3 care homes that used the service.

Our findings

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The way the practice was led and managed promoted the delivery of high-quality, person-centred care.
• The cervical screening rate remained below the 80% national target. Action was being taken to address this.
• Most staff had not received an appraisal within the last year. Action plans were in place to address this.

However, we have continued to rate the practice as requires improvement for providing responsive services because:

• All 4 indicators for patient satisfaction with access to appointments in the national GP patient survey were below the local and national averages and had continued to fall since our previous inspection in January 2023.
• Repeat prescriptions were not always provided in a timely manner.

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

• Review systems to improve the timeliness to the issuing of repeat prescription requests.
• Continue to review and improve their systems and processes to improve access to appointments. The CQC recognises the pressure that practices are currently working under and the efforts staff are making to maintain levels of access for their patients. At the same time, our strategy makes a commitment to deliver regulation driven by patients’ needs and experiences of care. Although we saw the practice was attempting to improve access, this was not yet reflected in the GP patient national survey data or other sources of patient feedback.
• Continue to embed into practice improvements to increase the cervical screening rate to the national target of 80%.
• Carry out their action plan to provide staff with annual appraisals.

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

I am taking this service out of special measures. This recognises the significant improvements that have been made to the quality of care provided by this service.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care