Background to this inspection
Updated
15 May 2017
Salisbury Walk-In Centre is a GP led service providing care when GP
practices are usually closed. It is situated in the centre of Salisbury. The service
is in a purpose built building which is used for the provision of other medical
services. These services are usually closed when the Salisbury Walk-In Centre
is open. Some facilities, such as the waiting room and toilets are shared with
these services. All patient services are located on the ground floor which
include; two consulting rooms and a reception. There was an automatic front
door, a loop system for the hard of hearing and a toilet with access for people
with disabilities.
The general Index of Multiple Deprivation (IMD) population profile for
the geographic area of Salisbury is in the second least deprivation decile. (An
area itself is not deprived: it is the circumstances and lifestyles of the
people living there that affect its deprivation score.) Average male and female
life expectancy for the clinical commissioning group area is 80 and 84 years,
which is above the national average of 79 and 83 years respectively.
The Salisbury Walk-in
Centre service is provided by Wilcodoc Limited. Leadership is provided by five
directors, three of whom are GPs. One of the GP directors was the Registered
Manager and the service manager had been registered with the CQC as the
Nominated Individual so they could speak to the CQC on behalf of the service.
The service is delivered by two salaried GPs who cover approximately 20%
of the opening hours with the remaining 80% being covered by a bank of regular
locum GPs and one advanced nurse practitioner locum. They are supported by two receptionists.
There is a service manager and four directors of the service who also provide
support.
The service is open between 6.30pm and 10pm from Monday to Friday, and between
8am and 8pm on Saturday, Sunday and all bank holidays. There is no appointment
system. Patients turn up and are seen in order of arrival unless a patient is
identified as having a medical priority.
The Salisbury Walk-in Centre service is commissioned by the Wiltshire
Clinical Commissioning Group.
The service provides
services from the following site:
-
Salisbury Walk-in Health Centre, Avon Approach,
Salisbury, Wiltshire, SP1 3SL
Updated
15 May 2017
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive
inspection at Wilcodoc (also known as Salisbury Walk-In Centre) on 21 March
2017. The service provides an out of hours service. Overall the service is
rated as good.
Our key findings across all the areas we
inspected were as follows:
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There was an open and transparent approach to
safety and an effective system in place for recording, reporting and learning
from significant events.
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Risks to patients were assessed and well
managed.
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Patients’ care needs were assessed and
delivered in a timely way according to need.
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Staff
assessed patients’ needs and delivered care in line with current evidence based
guidance. Staff had been trained to provide them with the skills, knowledge and
experience to deliver effective care and treatment.
-
There
was a system in place that enabled staff access to patient records, and the out
of hours staff provided other services, for example the local GP and hospital,
with information following contact with patients as was appropriate.
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Patients said they were treated with
compassion, dignity and respect and they were involved in their care and
decisions about their treatment.
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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.
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The service worked proactively with other
organisations and providers to develop services that supported alternatives to
hospital admission where appropriate and improved the patient experience.
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The service had good facilities and was well
equipped to treat patients and meet their needs.
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There
was a clear leadership structure and staff felt supported by management. The service
proactively sought feedback from staff and patients, which it acted on.
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The provider was aware of and complied with
the requirements of the duty of candour.
We saw one area of outstanding service:
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The service worked closely with local GP
practices and the clinical commissioning group to review the needs of its local
population and to secure improvements to services where these were identified. We
saw numerous examples of innovative service developments that had been proposed
and implemented by the service to support local needs. For example, in response
to an increase in the number of children attending the local accident and
emergency unit with a minor illness and an increase in non-elective admissions,
the service had worked with local GP practices and the local clinical
commissioning group (CCG) to develop a specialist out-of-hours paediatric
service that had reduced hospital attendance and admissions by this group of
patients.
The areas where the provider should make improvement are:
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Review the need to assess the clinical needs of patients who may have to
wait more than 30 minutes to be seen.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice