Highbridge Medical Centre is located in Highbridge, a town situated seven miles north of Bridgwater, on the edge of the Somerset Levels in the Sedgemoor district of the County of Somerset. The practice provides primary medical services to approximately 12,697 patients living in Highbridge and the surrounding area.

Data from Public Health England show that the practice had a higher than average population of patients over 65, ; 28%, in comparison with the clinical commissioning group (CCG) average of 23% and a national average of 17%. The population of Highbridge on average is older than the national average. In addition there are a large number of single parent families. The practice is situated in an area with less deprivation compared to national averages, with a deprivation score of 22% compared to the CCG average of 18% and the national average of 22%.

The practice was previously inspected by the CQC on 29 September 2015 and 2 August 2016 under the previous Provider. As a result of an inadequate rating, the service was placed into special measures. On 1 April 2017, Symphony Health Services became the registered provider for Highbridge Medical Centre. On 1 April 2017 Symphony Health Services became the registered provider for the location. We inspected the service location on 13 June 2017.

Symphony Health Services (SHS) is one of the NHS England Vanguard schemes, known as South Somerset Symphony programme. (As a subsidiary of Yeovil District Hospital NHS Foundation Trust). SHS currently has eight general practice locations within Somerset.

The practice is located in a purpose built surgery built in 1993 which is leased to SHS. The practice has a spacious waiting area with the ground floor and the consulting rooms are accessible to patients. The first floor provides administrative rooms. Within the building is an independent pharmacy. The locality health visitors’ service is based within the practice.

The practice has a Primary Medical Services contract (PMS) with NHS England to deliver general medical services. The practice provides enhanced services which included extended hours for appointments; facilitating timely diagnosis and support for patients diagnosed with dementia and minor surgery.

The practice is open from 8.30am to 6.30pm with emergency phone lines open from 8am. Extended hours surgeries are available on Wednesday evenings until 7pm and Thursday evenings until 8pm. The practice closes at 1pm one Tuesday per month for training. During this time patient care is provided by another practice under a reciprocal agreement.

The practice team includes 3.48 WTE (whole time equivalent) salaried GPs which equates to 35 clinical sessions per week, with a current vacancy of for 1.62 WTE. At the time of our inspection the hours for the vacancy were being filled with mostly locum GPs who had a specific long term contract with SHS. A further GP had been recruited and is due to commence employment later in the year which will reduces the GP vacancy to 0.5 WTE. The practice also employs five WTE practice nurses, two WTE health care assistants; one WTE advanced nurse practitioner, 0.75 WTE pharmacist, one WTE primary care practitioner and a practice manager. In addition, a permanent deputy practice manager had commenced employment and the practice has recruited additional administrative and reception staff. In addition the clinical lead GP for the practice undertakes patient care.

The practice works closely with a local community healthcare provider to provide a mental health practitioner for two sessions per week. A village agent attends the practice once weekly to provide support isolated, vulnerable and lonely patients with a signposting and referral service.

The practice has opted out of providing Out Of Hours services to their own patients. Patients can access a local provider which provides an NHS 111 and an Out Of Hours GP service.

[EJB1]At this inspection, or at previous inspections, or since new provider?