Archived: Broadstreet Medical Centre

Updated 4 October 2018

The provider of the service is Together First Limited. This is a group of local GP practices who have agreed to work together to offer a health service provided by clinicians with expertise in, understanding of, and commitment to their local communities. Together First Limited has five directors, four clinical whom are all local GPs with practices in Barking and Dagenham and one business director. Together First has another access hub based at Barking Hospital. Together First Ltd has contracted with BHR GP solutions a separate company that provides the call centre the extended access primary care hub.

The service is commissioned by the Local Clinical Commissioning Group (CCG) for the residents of Barking and Dagenham who are registered with a local GP practice. It is commissioned for patients who are assessed as having an urgent primary care need. To support NHS 111, A&E, GP practices and urgent care centres. It does not provide a service for patients who required on going treatment for long-term conditions, palliative care, and maternity care.

The call handling and Together First Ltd management team are based at CEME Innovations Centre, Marsh way, Rainham Essex RM13 8EU. This is operated by a business manager and assistant, a rota manager, two supervisors and a team of call handlers. Together First Ltd employs 18 doctors to cover the service and an advanced nurse practitioner.

The extended access service is located at Broadstreet Medical Centre, Morland Road, Dagenham

Essex, RM10 9HU. Patients book an appointment by telephoning, their GP practice, and other urgent care centres or calling the services direct line. The service does not see patients who walk in.

• The service operated from Monday to Friday from 6:30pm to 10pm.

• The call handlers book appointments from Monday to Friday from 2pm to 9pm and Saturday 9am to 5pm and Sunday 9am to 4pm.

The provider Together First Ltd is registered with the CQC to provide the regulated activity treatment of disease, disorder and injury.

Updated 4 October 2018

This service is rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at Broadstreet Medical Centre on 28 August and the 4 September 2018 as part of our inspection programme.

• The service had good systems in place to safeguard children and adults from abuse.

• The service reviewed safety incidents, and complaints and learned from them and improved their processes.

• The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

• Staff involved and treated people with compassion, kindness, dignity and respect.

• Patients were able to access care and treatment from the service within an appropriate timescale for their needs.

• The service had systems for sharing information with staff and other agencies to enable them to deliver safe care and treatment. However, the service did not have access to all of the patient’s medical records. The Clinical Commissioning Group confirmed that access to all patient notes was out of the services control. Although, recently more GP practices had moved to one computer software system and the service was looking at ways of funding this system.

• There was a strong focus on continuous learning and improvement by the provider.

The areas where the provider should make improvements are

• The provider should review the policies and standard operating procedures to ensure that they fully reflect the services practices and sites.

• The provider should continue to review the systems and protocols for the management and prevention of infection control. This should include the review of non-clinical staffs immunisation records and assurances from the landlord of the general cleaning of the premises.

• The provider should continue to review the management and storage of medicines, this should include a risk assessment of emergency drugs and the security of prescriptions.

• The provider should review the necessity for child oximeters for the monitoring a child’s pulse and heart rate.

• The provider should consider the use of interpretation services to aid staff at the call centre.

• The provider should review the training and appraisal system to ensure it includes all call handlers and has oversight of the more recent training of the advanced nurse practitioner.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice