Archived: Tollgate Health Centre

Updated 22 October 2015

Tollgate Health Centre is located on the outskirts of Colchester. The practice provides services for approximately 6,600 patients living in Tollgate and surrounding villages. The practice holds a General Medical Services (GMS) contract and provides GP services commissioned by NHS North East Essex Clinical Commissioning Group.

The practice is managed by two GP partners, two salaried GPs, one female GP registrar. The practice occasional takes students who are training to work in the health service, including trainee doctors and student nurses. Nursing staff include a nurse practitioner, a practice nurse who work part time and two healthcare assistants. The practice also employs a practice manager, reception staff, secretaries and administration staff.

The practice is open from 8.30am to 1pm and 2pm to 6.30pm on weekdays, with extended hours on a Tuesday until 7.30pm GP appointments are available between 9am and 11.50 am, and between 2pm and 6.20pm. Routine appointments can be pre-booked up to two weeks in advance in person, by telephone or online. Home visits and telephone consultations 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 Harmoni, 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 22 October 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Tollgate Health Centre on 22 June 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 older people, people with long-term conditions, Families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable 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, with the exception of those relating to recruitment checks.
• 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• 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 should make improvements.

Importantly the provider should:

• Ensure dissemination of learning from investigations is shared with all practice staff
• Provide management support and appraisals for the practice manager.
• Ensure blank prescription pads are logged and audited so that risks of misuse are mitigated.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 October 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 and patients at risk of hospital admission were identified as a priority. 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 patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 22 October 2015

This practice is rated as good for the care of families, children and young people. The practice provided childhood immunisations and appointments for these could be booked throughout the week to provide flexibility for working families. The practice provided a family planning service and a range of options for contraception. The GPs and nurses worked with other professionals where this was necessary, particularly in respect of children living in vulnerable circumstances. They had systems to identify and follow up children living in disadvantaged circumstances and worked in partnership with other professionals such as health visitors to monitor their well-being. Immunisation rates were in line with the local clinical commissioning group average. Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 22 October 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 22 October 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 as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 22 October 2015

This practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice held a register of people experiencing poor mental health and invited them to attend for an annual health check and other opportunistic checks were carried out at this time. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

Updated 22 October 2015

This practice is rated as good for the care of people living in vulnerable circumstances. The practice had a learning disability register and all patients with learning disabilities were invited to attend for an annual health check. Longer appointments were available for this and the practice used information in suitable formats to help them explain information to patients. The practice provided care and treatment to homeless people. Staff recognised that these patients frequently had multiple health and social difficulties and encouraged them to come back to the practice for on-going care.

Staff worked with other professionals to help ensure people living in difficult circumstances had opportunities to receive the care, support and treatment they needed. The staff team were aware of their responsibilities regarding information sharing and dealing with safeguarding concerns.