Archived: Tillingham Medical Centre

Updated 11 June 2015

Tillingham Medical Centre is situated in Southminster, Essex. The practice is one of 48 GP practices in the Mid Essex Clinical Commissioning Group (CCG) area. The practice has a general medical services (GMS) contract with the NHS. There are approximately 2700 patients registered there. They are a dispensing practice.

The practice has two GP partners, only one of whom works at the practice. The practice also employs a salaried GP. Between them they cover various surgeries throughout the week. There are two nurses working at the practice, one being a nurse practitioner. The dispensary is staffed by a manager and a dispensing assistant. There is a small team of reception and administration staff.

The practice is open for appointments from 7.40am to 6pm on Mondays and Thursdays and from 7.40am to 4pm on Tuesdays, Wednesdays and Fridays. Surgeries starting at 740am are for patients who work office hours or for school children so they could access services before they travelled to work/school. The practice is closed at weekends. The dispensary is open during surgery hours.

The practice has opted out of providing 'out of hours’ services to their own patients. If emergency medical help is required patients call the main practice telephone number and they are directed to an out of hour’s service. Otherwise non-urgent medical advice is available using the 111 system.

Updated 11 June 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Tillingham Medical Centre on 10 March 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective caring, responsive and well-led services. It was also good for providing services for older people, people with long-term conditions, families and young children, working age people, people whose circumstances made them vulnerable and those suffering from poor mental health.

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, including 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 needs to make improvements.

Importantly the provider should;

• Review their monitoring of medicines to ensure they are not stored beyond their expiry date.

• Improve the recording of checks and actions taken to promote patient safety. This includes meetings regarding safety incidents, cleaning arrangements and environmental checks.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 11 June 2015

The practice is rated as good for the care of people with long-term conditions. Patients were monitored and their healthcare needs reviewed regularly through routine appointments or by attending specialist sessions with trained staff. 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. For those patients with the most complex needs, the practice worked with relevant health and care professionals to deliver a multidisciplinary package of care. Patients were signposted to external organisations that provided support. A system was in place to recall patients to the practice to monitor their conditions. Patients with palliative care needs were regularly monitored and relatives and carers involved in the planning of their treatment. Routine health checks were available for patients.

Updated 11 June 2015

The practice is rated as good for the care of families, children and young people. There were systems in place to identify children vulnerable to abuse. Staff had received safeguarding training. Immunisation rates were relatively high for all standard childhood immunisations. Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this. Appointments were available outside of school hours and the premises were suitable for children and babies. Partnership working with community midwives and health visitors took place regularly.

Updated 11 June 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. Patients who were frail were monitored to reduce the risk of hospital admissions and visited in their homes by a GP. Monthly meetings took place with other healthcare professionals to identify care requirements. Patients in two care homes received regular visits from a GP. Patients suffering from dementia or nearing the end of their lives received support. Each patient over 75 had a named GP and could see a GP of their choice whenever available. Home visits and telephone consultations were available for those housebound or too ill to attend the practice. Vaccination programmes were readily available to help keep patients healthy.

Updated 11 June 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. Early morning appointments were available for those patients who had work commitments. A full range of health promotion and screening was available for patients.

Updated 11 June 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Patients were identified and their health monitored. People experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the management of people experiencing poor mental health, including those with dementia. Patients at risk of developing dementia were offered health checks to enable early identification of the condition and to discuss treatment. The practice signposted patients experiencing poor mental health to various support groups and voluntary organisations including MIND and SANE. Staff had received training in the care for people with mental health needs and dementia. Patients with dementia and their relatives were supported by the practice to understand the care and treatment required.

Updated 11 June 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice held a register of patients who had a learning disability. Health checks were carried out annually or sooner if required and longer appointments were available for them. The practice undertook health assessments for patients with a learning disability who lived at a local care home. Patients were signposted to external organisations that provided support. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.