Bexley Health Neighbourhood Care GP Hub (BHNC GP Hub) at Erith and District Hospital

Updated 3 August 2021

Bexley Health Neighbourhood Care GP Hub (BHNC GP Hub) at Erith and District Hospital operates from Northumberland Heath Medical Centre, Hind Crescent, Erith, Kent DA8 3DB. The service is provided by Bexley Health Neighbourhood Care C.I.C, a community interest company and a GP Federation, and is commissioned by Bexley Clinical Commissioning Group (CCG). The BHNC GP Hub at Northumberland Heath Medical Centre is located within the Erith and Distirct hospital site, and consists of one consultation room and a reception area. The Hub has been in operation since January 2015.

The service is open from 6.30pm to 8pm on Monday to Friday, and 8am to 8pm on Saturdays and Sundays, 365 days a year.

The BHNC GP Hub service is available to any patient registered to a GP Practice in the borough of Bexley and who consents to their medical record being shared.

Appointments can be booked by the GP practice where the patient is registered or NHS 111.

The service is commissioned to provide 37,000 GP appointments per annum for a patient population size of 240,000. The BHNC GP Hub service does not offer a walk-in service and all appointments must be pre-booked. The service includes assessment, investigation, diagnosis, treatment (including issuing a prescription) and referrals.

The provider has centralised governance for the service which are coordinated by the BHNC board of directors: the managing director and three directors, who are all clinicians as senior GPs in local practices. The management team are the Chief Operating Officer, Clinical Operations Manager, Head of Quality and Governance, Hub Service Manager and GP Clinical Lead.

Clinical care is provided by sessional GPs that work locally and provide regular sessional shifts.

The non-clinical service team consists of leaders responsible for each area of the business such as finance, human resources, operations and clinical performance reporting to the Chief Operating Officer. A team of reception and administrative staff members support the administration of services, and the service receives external support from the primary care network.

The provider is registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures and treatment of disease, disorder or injury.

Updated 3 August 2021

This service is rated as Requires improvement overall. (Previous inspection 06 2019 – Requires improvement)

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Requires improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at Bexley Health Neighbourhood Care GP Hub (BHNC GP Hub) at Erith and District Hospital on 24 May 2021. This inspection was carried out as part of our inspection programme and to follow up on breaches of Regulation 12 Safe care and treatment and Regulation 17 Good governance.

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, considering the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Conducting staff interviews using video conferencing and questionnaire
• Reviewing patient records to identify issues and clarify actions taken by the provider
• Requesting evidence from the provider
• A short site visit

Our findings

• The service had risk management arrangements in place, although some were only recently established.
• The service took a responsive approach in dealing with safety incidents, learning from them and using them to improve their processes, but the preventative element to incidents management was not in place.
• The service did not routinely review the effectiveness and appropriateness of the care it provided. This meant they could not be consistently assured that care and treatment was delivered according to evidence- based guidelines.
• Patients were able to access care and treatment from the service within an appropriate timescale for their needs.

The areas where the provider must make improvements as they are in breach of regulations are:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care