Archived: Dickens Place Also known as Dickens Place Surgery

Updated 30 April 2015

Dickens Place Surgery is located on the outskirts of Chelmsford. The practice provides services for approximately 5918 patients living in the immediate area. The practice holds a General Medical Services (GMS) contract and provides GP services commissioned by NHS Mid Essex Clinical Commissioning Group.

The practice is managed by two partner GPs supported by clinical staff; two salaried GPs, registrar,(GPs in training) three practice nurses and a specialist nurse in diabetes and coronary heart disease. The practice also employs a practice manager, an assistant manager, five reception staff and two medical secretaries who job share.

The practice is open from 8.00am to 7pm weekdays. GP appointments are available between 9am and 12:00 and between 4pm to 6pm on Monday to Friday. Late clinics are provided three evenings a week between 6.30pm and 7.30pm on Tuesday, Wednesday and Thursday. Nurse led appointments and clinics are also available with ante-natal clinics held on Wednesday afternoons. Routine appointments can be pre-booked up to six weeks in advance in person, by telephone or online and home visits are available daily as required.

The practice has opted out of providing GP services to patients outside of normal working hours such as evenings and weekends. During these times GP services are provided by the 111 service, an out-of-hours advice, emergency and non-emergency treatment service. Details of how to access out-of-hours advice and treatment is available within the practice, on the practice website and in the practice leaflet.

Updated 30 April 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dickens Place Surgery on Wednesday 11 March 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing well-led, effective, caring and responsive services. It was also good for providing services for the older people, people with long-term conditions, families, children and young people, working age people (including those recently retired and students), people living in vulnerable circumstances, and people experiencing poor mental health (including people with dementia).

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed, except those relating to reference checks for recruitment of staff.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

However there were areas of practice where the provider needs to make improvements

Importantly the provider should;

• Maintain a record of training undertaken by staff.
• Have access to emergency oxygen

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 30 April 2015

The practice is rated as good for the care of people with long-term conditions. Nursing staff had lead roles in chronic disease management such as diabetes, Asthma clinic, Spirometry and Chronic Obstructive Pulmonary Disease (COPD) clinic , Chronic Heart Disease (CHD) clinic, Chronic Kidney Disease clinic and Hypertension clinics. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

We found specialist nurses trained in operating onsite facilities of Spirometry, an electrocardiogram which records the electrical activity of the heart and 24 hour Ambulatory blood pressure monitoring, contributing to reducing hospital referral rates and waiting times and facilitating diagnosis of Asthma, COPD and Hypertension. Patients have personalised care plans and were provided information to support self management of their conditions.

Updated 30 April 2015

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. The practice had an appointed clinical lead for child protection concerns. Immunisation rates were high for all standard childhood immunisations and non attendance was followed up. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives who attended the practice on Wednesday afternoons to provide antenatal services. They work closely with the GPs who conduct post natal maternal check ups and six weekly baby checks.

Updated 30 April 2015

This practice is rated as good for the care of older people. Patients over the age of 75 had a named GP and were included on the practice’s ‘unplanned admissions avoidance’ list to alert staff to people who may be more vulnerable. The GPs carried out visits to people’s homes if they were unable to travel to the practice for appointments. The practice worked with local care homes to provide a responsive service to the people who lived there. They maintain a frailty register working with partner services to coordinate patient care.

The practice identified people with caring responsibilities and those who required additional support which was recorded on their patient record. Patients with caring responsibilities were invited to register as carers so that they could be offered support and advice about the range of agencies and benefits available to them. Patients also benefit from access to independent specialist advocacy services.

Updated 30 April 2015

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, flexible and offered continuity of care. The practice was proactive in offering online services, including the opportunity to book appointments six weeks in advance and arrange repeat prescriptions. The practice provided a full range of health promotion and screening that reflects the needs for this age group.

Updated 30 April 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice has an appointed mental health lead and a mental health specialist nurse. The practice invites people with poor mental health to attend annual physical health checks and follows up on non attendance. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. The practice has focussed on improving their dementia care to patients and have undertaken specific training and enhanced their outcomes for patients. Patients also benefit from accessing independent specialist advocacy services.

Updated 30 April 2015

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. It had carried out annual health checks for people with a learning disability and offered longer appointments for people with a learning disability, where required.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people through opportunistic and scheduled reviews. 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. Patients also benefit from accessing independent specialist advocacy services with knowledge of supporting vulnerable people, carers and people living independently.