Oakham Medical Practice

Updated 11 January 2023

Oakham Medical Centre is located in Rutland at:

Cold Overton Road

Oakham

Rutland

LE15 6NT

01572 722621

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, family planning, maternity and midwifery services and treatment of disease, disorder or injury and surgical procedures.

The practice offers services from both a main practice and in the neighbouring Rutland Memorial Hospital where the practice are commissioned to deliver a minor injuries same day service. Patients can access services at either of these sites, although they need to fulfil the necessary criteria to be seen by the same-day team working at the hospital.

Oakham Medical Practice is situated within the NHS Leicester, Leicestershire and Rutland Integrated Care Board (LLR ICB) and delivers General Medical Services (GMS) to a patient population of approximately 15,147. This is part of a contract held with NHS England. An Integrated Care Board (ICB) is a statutory organisation bringing the NHS together locally to improve population health and establish shared strategic priorities within the NHS.

The practice is part of a wider network of GP practices and is part of Rutland Health Primary Care Network (PCN) with 3 other locally based GP practices.

Information published by Public Health England shows that deprivation within the practice population group is in the 10th lowest decile (10 of 10). The lower the decile, the more deprived the practice population is relative to others, and therefore Oakham Medical Practice is in the least deprived decile.

According to the latest available data, the ethnic make-up of the practice area is 97.4% white,1.1% Asian, and 1.5% other non-white ethnic groups.

The age distribution of the practice population shows higher percentages of older patients compared to national averages, but in alignment with their PCN. There are also lower percentages of patients aged 20-50 registered at the practice compared with national figures. There is a high prevalence of long-term conditions amongst registered patients.

There is a team of 5 GP partners and 4 salaried GPs working at the practice. The GPs are supported by 2 advanced nurse practitioners, 7 practice nurses, 4 health care assistants, 1 phlebotomist and 2 pharmacists. The clinical team is supported by a team of approximately 20 reception/administration staff. Two practice managers provide managerial oversight. The practice is an approved training practice and provides training to GP Registrars as part of their ongoing training and education. There were 5 GP registrars working at the practice at the time of our inspection.

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 and online consultations, and advance appointments.

Patients can obtain additional appointments in the evening and weekends via a local enhanced access service. This is provided onsite on Wednesdays 6.30pm-8.00pm and remotely on Fridays 6.30pm-8.00pm.

Out of hours services are provided by DHU Healthcare when the practice is closed.

Updated 11 January 2023

We carried out an announced inspection at Oakham Medical Practice on 29 November 2022. Overall, the practice is rated as Good.

At our previous inspection in April 2022, the practice was rated as inadequate overall and inadequate for the key questions of effective and well-led. The key questions of safe and responsive were rated as requires improvement, whilst caring was awarded a good rating. The service was placed into special measures.

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

Why we carried out this inspection.

This inspection in November 2022 was a comprehensive inspection including a site visit to review progress with the action plan the provider had sent us following the last inspection, and to reassess their special measures status.

Following this inspection the practice is now rated as good overall and for all the key questions with the exception of safe, which remains rated as requires improvement.

How we carried out the inspection

Throughout the pandemic the Care Quality Commission (CQC) has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend less time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Conducting staff interviews using video conferencing.
• Completing remote clinical searches on the practice’s patient records system and discussing findings with the provider.
• Requesting evidence from the provider to be submitted electronically.
• A shorter site visit.

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 have rated this practice as Good overall

We found that:

• The practice did not always ensure care and treatment was provided in a safe way to patients. We found some concerns relating to medicines management and safety alerts.
• 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.
• Patients could mostly access care and treatment in a timely way, although further work was required to work with patients to promote new ways of working.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

We found the following example of outstanding practice:

• The practice had designed and implemented a suite of auto consultation templates. The focus was initially to ensure any high risk medicines were fully reviewed within recommended timescales by following a step by step automated process. This was being developed for use on a wider scale, for example, to be used as a guide to assess patients presenting with a potential emergency presentation such as sepsis.

We found the following breach of regulations. The provider must:

• Ensure care and treatment is provided in a safe way to patients.

In addition, the provider should:

• Continue to review and take any action needed in relation to access in terms of patient experience and satisfaction in collaboration with others such as their patient participation group, and with external agencies.
• Complete the collation of evidence that staff have documented evidence of appropriate immunisations in line with national guidance.
• Utilise staff involvement in the development of change and the formation of future service objectives.
• Widen the scope of DNACPR documentation to look at all parameters and not solely a clinician’s signature.
• Always record the reason to explain any deviation from the expected vaccine fridge temperature range on manual temperature logs.

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.

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

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services