• Doctor
  • GP practice

Chiltern House Medical Centre

Overall: Good read more about inspection ratings

45-47, Temple End, High Wycombe, HP13 5DN (01494) 439149

Provided and run by:
Primary Care Management Solutions Ltd

Latest inspection summary

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Background to this inspection

Updated 10 June 2021

Chiltern House Medical Centre is a GP practice located in a 17th century Grade II listed building in High Wycombe, Buckinghamshire. The practice has approximately 6,500 patients and is one of the practices within Buckinghamshire Clinical Commissioning Group (CCG).

The practice has been through a challenging three years with changes in provider and a number of GPs, managers and staff leaving, which had caused instability in the practice. Primary Care Management Solutions Limited, known as PCMS provided caretaker management of the practice between April 2019 and August 2019 and took over the contract following a procurement exercise led by the CCG in September 2019.

Clinical services are provided from:

  • Chiltern House Medical Centre, 45 – 47 Temple End, High Wycombe, Buckinghamshire HP13 5DN

The practice website is:

  • www.chilternhousemedicalcentre.co.uk

The clinical team consists of two salaried GPs, one advanced nurse practitioner, a lead nurse, a practice nurse and a health care assistant. At the time of the May 2021 inspection, a clinical pharmacist provided medicines optimisation services and was employed via a clinical recruitment agency. To further supplement the medicines team, the practice also accessed remote pharmacy and medicines support. A practice business manager, an operations manager and a team of reception and administrative staff undertake the day to day management and running of the practice. When required, the practice team could access additional support from the provider (PCMS) which included the Chief Executive Officer who was also the Registered Manager.

According to national data, the practice is located in an area of low deprivation, meaning very few patients are affected by deprivation in the locality. However, there are pockets of high deprivation within the practice boundary. The practice population has a higher proportion of patients aged between 15 and 24 and 50 and 59 when compared to the national average. There is also a high percentage of transient patients and patients from ethnic minority backgrounds at Chiltern House Medical Centre. People living in more deprived areas tend to have greater need for health services and people outside of the country for long periods often has an impact on screening and recall programmes.

The practice provides services for a high proportion of patients experiencing a long-standing health care condition, 55% compared to the local CCG average of 49% and a national average of 52%.

The practice also provides primary care GP services for a local nursing home (45 patients).

PCMS ‘The Provider’ is registered with CQC to deliver the following Regulated Activities:

  • Diagnostic and screening procedures
  • Family planning services
  • Maternity and midwifery services
  • Surgical procedures
  • Treatment of disease, disorder or injury

The practice is part of a wider network of GP practices, this is known as a Primary Care Network (PCN). Chiltern House Medical Centre is a member of Dashwood PCN with five other local practices.

Chiltern House Medical Centre is open between 8.00am and 6.30pm Monday to Friday. Extended surgery hours are offered on Tuesday and Friday evenings until 8pm, Friday mornings from 7am the practice had reintroduced nurse led Saturday morning clinics. The practice have opted out of providing out of hours care when the practice is closed. This is offered by NHS111 telephone service who will refer to the out of hours GP service if required.

Due to the enhanced infection prevention and control measures put in place since the pandemic and in line with the national guidance, most GP appointments were telephone consultations. If it was clinically appropriate, a clinician would see a patient face-to-face following a telephone consultation.

Overall inspection

Good

Updated 10 June 2021

We carried out an announced inspection at Chiltern House Medical Centre in High Wycombe, Buckinghamshire on 18 May 2021.

Overall, the practice is rated as Good.

The key questions at this inspection are rated as:

  • Are services safe? – Good
  • Are services effective? – Good
  • Are services caring? – Good
  • Are services responsive? – Good
  • Are services well-led? - Good

Why we carried out this inspection

This inspection was completed following changes in the registration of this practice to a new provider of care and treatment. These changes were introduced on a temporary basis in April 2019 and permanently in September 2019.

How we carried out the inspection

Throughout the pandemic 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 a minimum amount of 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 clinical searches on the practice’s patient records system and discussing findings with the provider
  • Reviewing patient records to identify issues and clarify actions taken by the provider
  • Requesting evidence from the provider
  • A short site visit
  • Engagement with external stakeholders
  • Discussions with the patient participation group

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 and Good for all population groups.

We found that:

  • It was evident the practice had gone through a period of transition since the change of provider in September 2019. Improvements had been made, systems implemented to manage, and monitor risks and patient feedback was improving. Staff we spoke with recognised the endeavours of the new leadership team and were keen to be part of the new developments.
  • 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 practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic.
  • The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
  • The practice had clear and visible clinical and managerial leadership and supporting governance arrangements. There was a high level of constructive engagement with staff and all staff we spoke with told us they felt they were an integral part of the practice, they felt valued and safe during the pandemic.

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

  • Look at methods to improve the uptake of cervical cancer screening for eligible patients and improve the identification of people with caring responsibilities.

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