Ramsey Health Centre

Updated 24 June 2016

Ramsey Health Centre provides General Medical Services to approximately 6,843 patients in the rural market town of Ramsey. The practice offers dispensing services to its patients who live more than one mile from the nearest chemist. Ramsey is listed in the 10% most income deprived areas in the district. However good transport links to London, Cambridge and Peterborough attracts city professionals to the area. The practice area covers the town and the immediate surrounding rural area. There is a strong migrant population some of whom do not have English as their first language. Translation services are available for patients. Translation services are also available on the practice website and information in other languages is available on the booking in screen and in leaflets.

According to information taken from Public Health England, the patient population has a higher than average number of patients aged 45 – 85+ years, a lower than average number of patients aged 0-14 years and 25 -39 years compared to the practice average across England.

The practice team consists of five GP partners, (two female and three male), one female salaried GP and two female GP registrars. There are four female practice nurses including a nurse team lead and one health care assistant. There are two practice managers who are supported by a patient services’ supervisor, a dispensary manager and a number of dispensers, administration and patient services staff.

The practice is open from 8am to 1pm and 2pm to 6pm Monday to Friday. Appointments are from 8.30am to 11.50am every morning and from 3pm to 5.30pm daily. The duty GP is on-site from 8am to 6.30pm with telephone appointments available for the first half of the morning sessions. The dedicated duty GP responds to any urgent appointments on the day. Dispensary opening times are from 8am to 1pm and 3pm to 6pm Monday to Friday, with the exception of Thursday afternoons when the dispensary remains closed to non-urgent medication requests. Extended hours appointments are offered on Tuesday evenings from 6pm to 8pm and Wednesday mornings from 7.45 am to 8.30am with both GP and nurse appointments available.

In addition to appointments that can be booked up to six weeks in advance, urgent appointments are also available for people that need them. The practice offers a range of appointment options which include; pre-bookable appointments follow up appointments, on-line access, and telephone consultations. These are supported by telephone access to a GP for those patients who do not require a face to face consultation. The appointment system is continually reviewed by the management team to establish any increase in demand and to warrant an increase in access.

The practice is a training practice and supports the training of medical students and GP registrars.

The practice does not provide GP services to patients outside of normal working hours such as nights and weekends. During these times GP services are provided via the 111 service.

Updated 24 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Ramsey Health Centre on 14 April 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Urgent appointments with a GP were available on the same day.
• Information about services and how to complain was available and easy to understand.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management.
• The practice proactively sought feedback from staff and patients, which it acted on.
• The practice was aware of and complied with the requirements of the Duty of Candour.

The areas where the provider should make improvement are:

• Continue to encourage and improve the uptake of breast screening for patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 June 2016

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.
• Performance for diabetes related indicators was better in comparison to the national average. With the practice achieving 96.2% in comparison to the CCG and national average of average of 89%.
• Flu vaccination rates for the over 65s were 75%, and at risk groups 45%. These were comparable to previous year’s national averages.
• 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 24 June 2016

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

• There were systems in place 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 A&E attendances. Immunisation rates were comparable with local and national averages 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 practice uptake for female patients screened for breast cancer in the last 36 months at 56% was low in comparison to the CCG and national average of 72%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, health visitors and school nurses.
• The practice encouraged chlamydia testing for the under 24 age group. At the time of the inspection the practice hosted the Young Persons Clinic weekly which provided sexual health advice and contraception clinic for anyone under 25 years. However we were told that the practice had just been told this service was being withdrawn due to a lack of funding.

Updated 24 June 2016

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 population.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice would contact all patients after their discharge from hospital to address any concerns and assess if the patient needed GP involvement at that time.
• The practice offered health checks for patients aged over 75.
• The practice triaged all home visit requests to facilitate earlier visits where hospital admission may be an outcome.
• Nationally reported data showed that some outcomes for patients for conditions commonly found in older people including rheumatoid arthritis were above local and national averages.
• The practice provided medical support to three local nursing homes with a total of 63 registered patients. GPs undertook fortnightly ward rounds to the homes and in addition provided medical services to six interim care beds at a local nursing home. This service was supported by members of the administration team who collated information and co-ordinated GP visits working closely with the home managers and nursing staff.

Updated 24 June 2016

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 population, those recently retired and students had been identified and the practice had adjusted the services it offered to 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.

• The practice offered a ‘Commuter’s Clinic’ on Tuesday evenings from 6pm to 8pm and Wednesday mornings from 7.45am to 8.30am with both GP and nurse appointments available, for patients who could not attend during normal opening hours.

Updated 24 June 2016

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

• 100% of patients diagnosed with dementia who had their care reviewed in a face to face meeting from 2014 to 2015 which was comparable to the national average/ worse than the national average.
• The percentage of patients experiencing poor mental health who had a comprehensive, agreed care plan documented in their record, in the preceding 12 months (01/04/2014 to 31/03/2015) was 98% which was above the national average of 88%.
• 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 had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• The practice had a system in place 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 24 June 2016

The practice is rated as good for the care of 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.
• The practice offered longer appointments for patients with a learning disability.
• 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.