5 June 2018
Ivel Medical Centre is situated in the Biggleswade area of Bedfordshire. The practice provides general medical services for approximately 12,600 patients living in Biggleswade and surrounding areas. The practice population is predominantly white British along with a small ethnic population of mixed race, Asian, black and other races. The practice has a higher than average working age population due to its location in the commuter belt for London.
The practice has five GP partners (two female and three male) and three salaried GPs (one female and two males). There are two practice nurses (female), two minor illness nurses (females), a practice matron (female) and an emergency care practitioner (male). The nursing team is supported by two health care assistants (females). There is a practice manager who is supported by an office manager and a clinical manager. The practice is also supported by a team of administrative and reception staff.
Ivel Medical Centre is a dispensing practice able to offer dispensing services to those patients on the practice list who lived more than one mile (1.6km) from their nearest pharmacy. The dispensary is open from 8.30am to 12.15pm and 2.30pm to 6.00pm Monday to Friday. There are four staff attached to the dispensary. The practice operates from a new purpose converted low rise building and patient consultations and treatments take place on ground level. There is a car park outside the surgery with disabled parking available.
The practice is open Monday to Friday from 8.00 am to 6.30pm. The practice offers a variety of access routes including telephone appointments, on the day appointments, home visits and advance pre-bookable appointments. Walk-in appointments are available Monday to Friday from 8.30am to 9.30am. When the practice is closed out of hours services are provided by the Herts Urgent Care and they are accessed via the NHS 111 service.
5 June 2018
This practice 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 Ivel Medical Centre on 24 April 2018 as part of our regulatory purposes.
At this inspection we found:
- The practice had good systems to manage risk so that safety incidents were less likely to happen. When incidents did occur, the practice learned from them and improved their processes.
- The practice had reviewed and developed an innovative skill mix within the practice. For example, they employed an emergency care practitioner (previously trained as a paramedic) who worked as part of the duty team, providing consultations to patients presenting with acute same day conditions.
- Although effective monitoring processes were in place, which included health and safety, infection prevention control, training and appraisals. During our inspection the practice was unable to provide evidence to demonstrate that an effective employee immunisation programme was in place. Specifically, evidence was not in place to demonstrate that relevant staff had been immunised against infectious diseases such as measles, mumps and rubella (MMR).
- The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered in accordance with evidence based guidelines. Support and monitoring was in place for nurse prescribers.
- Staff treated patients with compassion, kindness, dignity and respect. All staff had received equality and diversity training.
- Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
- Information on the complaints process was available for patients at the practice and on the practice’s website. There was an effective process for responding to, investigating and learning from complaints.
- Staff had the skills, knowledge and experience to carry out their roles and there was a strong focus on continuous learning and improvement at all levels of the organisation. Staff we spoke with felt supported by the practice.
- The practice had systems and processes to manage and mitigate risks to patients and staff. However, during our inspection we found that the practice was not following some of their policies, for example there was no health and safety risk assessment undertaken and we also found gaps in training for a staff member in infection prevention control.
- Clinicians knew how to identify and manage patients with severe infections such as sepsis.
- We found that clinicians were using an ineffective system to deal with hospital correspondence which posed a risk if required actions were not followed up.
- We found that the practice did not display information about the Patient Participation Group (PPG) and bereavement support services in the practice.
- Arrangements for dispensing medicines at the practice kept patients safe.
The areas where the provider should make improvements are:
- Ensure that an effective employee immunisation programme is in place so that staff working in general practice receive the immunisations that are appropriate for their role.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice