Didcot Health Centre Practice

Updated 7 April 2017

Didcot Health Centre Practice provides primary medical care services to more than 17500 patients in Didcot and the surrounding villages of semi-rural Oxfordshire. The practice area has an estimated low level of socio-economic deprivation, meaning few patients are affected by deprivation locally. The population is predominantly white British with only 2.5% registered patients being of Asian descent, just over 1% of mixed race background and 1% originating from other non-white ethnic groups. There is a larger than average population of young patients (from birth to four years) and working age adults (up to age 60) with a lower number of older working patients and elderly (60 to 75+). Employment is high in the area with very low unemployment figures reported.

The practice has 11 GP partners (three male, eight female) and one salaried GP (female). The GPs offer 66 sessions per week between them which equates to a whole time equivalent (WTE) of 7.4 full time GPs. There is also a regular locum GP (female) and two GP ST3 trainees (a GP ST3 trainee is a qualified doctor who is undergoing their final year of study and exams to become a GP).The nursing team consists of an Advanced Nurse Practitioner (female), a Practice Nurse Team Leader (female), six practice nurses (all female) and two healthcare assistants (both female). There are 6.1 WTE full time nurses.

The practice is supported by a practice manager, a personal assistant, a data quality manager, a finance assistant, an administration and secretarial manager, a secretary, six administration staff, two summarisers, four reception team leaders and eleven receptionists.

Didcot Health Centre Practice is located in a purpose built, two storey building in a semi-rural area. There is ample parking available and designated disabled parking spaces. The entranceway has automatic entrance doors which lead to the reception and waiting room area. There are ten GP consultation rooms and four nurse treatment rooms which are accessible from the waiting area on the ground floor. There are two patient toilet facilities including a disabled toilet with emergency pull cord. Baby change facilities are also available.

Didcot Health Centre Practice is open between 8am and 6.30pm Monday to Friday. Appointments vary daily depending on the GP available. Morning appointments start from 8am to 8.30am and finish between 12pm and 12.30pm. Afternoon appointments commence between 2.30pm and 3pm and finish between 5.10pm and 5.40pm. Extended hours appointments are offered on Mondays and Thursdays from 6.30pm until 7.30pm and alternate Saturdays from 9am to 12pm.

Out of hours cover is provided through the NHS 111 telephone service.

All services are provided from:

Britwell Road, Didcot, Oxfordshire, OX11 7JH

Updated 7 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Didcot Health Centre Practice on 6 July 2016. The practice was rated as requires improvement for providing safe services and the overall rating for the practice was good. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for Didcot Health Centre Practice on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 10 March 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 on 6 July 2016. 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:

• The practice had improved their communication of learning and actions taken following significant events. All staff had access to an update on the computer system and “practice education points” were discussed at team meetings.

• The practice had reviewed the cold chain policy, fridge temperature recording and ensured vaccine safety was maximised.

• The practice had reviewed their prescription security protocols to ensure blank prescriptions were securely stored.

• The practice had reviewed the storage of an emergency medicine used to treat low blood sugar. They had ensured it was stored correctly and all staff knew of its location.

The practice had reviewed their carers support and updated their carers’ notice board to highlight areas where support was available. One of the non-clinical staff had undertaken training to support carers and the practice were facilitating the Alzheimer’s support group once per month.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 12 September 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.

• 81% of patients with diabetes had achieved a target blood level of 64mmol or below compared to the CCG average of 79% and national average of 78%.

• 86% of patients with chronic obstructive pulmonary disease (COPD) had received a review including an assessment of breathlessness compared to the CCG average of 91% and national average of 90%.

• 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 12 September 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 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.

• 81% of women aged between 25 and 64 had a record of a cervical screening test performed within the previous five years compared to the CCG average of 83% and national average of 82%.

• 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 district nurses.

Updated 12 September 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 patient in its population.

• The practice was responsive to the needs of older patient, and offered home visits and urgent appointments for those with enhanced needs.

• There was a dedicated emergency contact number for older patients with complex or end of life care needs. This ensured a GP was contactable quickly without the patient needing triage. The number was also given to other healthcare professionals and carers who were looking after patients in the community.

Updated 12 September 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 and flexible. However, the addition of a third duty doctor has reduced continuity of care as patients will see or speak to whichever GP is available on the day.

• 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.

• 78% of female patients aged between 50 and 70 had been screened for breast cancer in the preceding 36 months compared to the CCG average of 75% and national average of 72%.

• 56% of patients aged between 60 and 69 had been screened for bowel cancer in the preceding six months compared to the CCG average of 57% and national average of 55%.

Updated 12 September 2016

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

• 87% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months compared to the CCG average of 85% and national average of 84%.

• 86% of patients with a diagnosed severe mental health condition had a care plan compared to the CCG average of 89% and 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 12 September 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 held a register of carers, but did not offer any proactive support for them. Some did not have a flag on the computer system alerting GPs to their carer status.
• 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.