Archived: Sheppey NHS Healthcare Centre

Updated 19 October 2020

• The registered provider is DMC Healthcare Limited which is a primary care at scale organisation that delivers regulated activities at three registered locations in England.
• Sheppey NHS Healthcare Centre is located at Sheppey Community Hospital, Plover Road, Minster-on-Sea, Kent, ME12 3LT. The practice has an alternative provider medical services contract with NHS England for delivering primary care services to the local community. Primary medical services are available to registered patients via an appointments system, a walk-in service and a mobile service. However, the mobile service is suspended due to COVID-19. Primary medical services are also available to patients not registered at the practice via the walk-in service and the mobile unit (when not suspended). The practice website is www.sheppeyhealthcarecentre.nhs.uk.
• As part of our inspection we visited Sheppey NHS Healthcare Centre, Sheppey Community Hospital, Plover Road, Minster-on-Sea, Kent, ME12 3LT only, where the provider delivers registered activities. The provider also delivers regulated activities from a mobile unit which travels to various supermarket locations in Queenborough, Kent, Sittingbourne, Kent and Sheerness, Kent (although currently suspended due to COVID-19).
• Sheppey NHS Healthcare Centre has a registered patient population of approximately 8,500 patients.
• There are arrangements with other providers (MedOCC) to deliver services to patients outside of the practice’s working hours.
• The practice staff consists of one salaried GP (female), one practice manager, one assistant practice manager, two advanced nurse practitioners (one male and one female), one practice nurse (female), one community psychiatric nurse (male), one acute care practitioner (paramedic) (female), one prescribing pharmacist (male), as well as administration and reception staff. The practice also employs locum GPs via an agency. Practice staff are also supported by the DMC Healthcare Limited management staff.
• Sheppey NHS Healthcare Centre is registered with the Care Quality Commission to deliver the following regulated activities: diagnostic and screening procedures; family planning; maternity and midwifery services; surgical procedures; treatment of disease, disorder or injury.

Updated 19 October 2020

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Sheppey NHS Healthcare Centre on 10 January 2017. 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 a system for reporting and recording significant events.

• There were systems, processes and practice to help keep patients safe.

• Risks to patients were assessed and managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• There was evidence of clinical audits driving quality improvement.
• Staff had been trained to provide them with 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.
• The practice had a website and patients were able to book appointments, order repeat prescriptions and view their records online.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• 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 gathered feedback from patients through the patient participation group (PPG), complaints received, patient surveys and by carrying out analysis of the results from the GP patient survey and the Friends and Family Test.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw the following area of outstanding practice:

• The practice employed a wide range of staff with specific skills to compliment those of GPs and nurses working at the practice and enhance the services available to patients. For example, a prescribing pharmacist, a non-prescribing pharmacist, an acute care practitioner (paramedic) and a community psychiatric nurse.

The areas where the provider should make improvements are;

• Consider expediting the replacement of waiting room chairs with those that are covered in materials which are easy to clean.

• Revise systems to help ensure all clinical equipment is calibrated regularly in accordance with manufacturers’ guidance.

• Continue to implement and monitor the results of plans to improve patient satisfaction scores.

• Continue to identify patients who are also carers to help ensure they are offered appropriate support.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 February 2017

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 comparable to the local clinical commissioning group (CCG) average and national average. For example, 74% of the practice’s patients with diabetes, on the register, in whom the last IFCC-HbA1c was 64 mmol/mol or less in the preceding 12 months compared with the local CCG average of 68% and national average of 69%.
• Longer appointments and home visits were available when needed.
• All these patients had a structured annual review to check their health and medicine needs were being met. The practice employed pharmacists who provided additional support to meet patients’ ongoing medicine requirements. 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 28 February 2017

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

• There were systems 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 accident and emergency attendances.
• Childhood immunisation rates for the vaccinations given were better than the clinical commissioning group (CCG) averages. For example, childhood immunisation rates for the vaccinations given to five year olds ranged from 90% to 97% compared to the local CCG averages which ranged from 86% to 95%.
• 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 percentage of the practice’s female patients aged 25 to 64 years whose notes recorded that a cervical screening test had been performed in the preceding five years was 82%. This was comparable to the local CCG average of 81% and national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice worked with midwives and health visitors to help meet the needs of this patient population group.

Updated 28 February 2017

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, longer appointments and urgent appointments for those with enhanced needs.
• Patients over the age of 75 years had been allocated to a designated GP to oversee their care and treatment requirements.
• The practice employed staff with specific skills to support some needs of older patients. For example, the practice pharmacists updated patients’ medicine records on receipt of discharge letters from acute admissions and coordinated with community pharmacies to help ensure patients’ dosset boxes were updated accordingly and in a timely manner.

Updated 28 February 2017

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 help ensure these were accessible, flexible and offered continuity of care.
• Extended hours appointments were offered Monday to Friday 6.30pm to 8pm as well as Saturday and Sunday 8am to 8pm to help meet the needs of this patient population group. Services were also provided via a walk in service and a mobile unit.
• The practice was proactive in offering online services, as well as a full range of health promotion and screening that reflected the needs for this age group.

Updated 28 February 2017

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

• 77% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the local clinical commissioning group (CCG) average and national average of 84%.
• Performance for mental health related indicators was better than the local CCG average and national average. For example, 92% of the practice’s patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in their records in the preceding 12 months compared with the local CCG average of 93% and national average of 89%.
• 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 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.
• The practice employed staff with specific skills to support some needs of patients in this population group. For example, the community psychiatric nurse reviewed all patients with dementia, mental health illness and some with depressive illness.

Updated 28 February 2017

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 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.