Thatcham Health Centre Also known as Thatcham Medical Practice

Updated 21 December 2016

Thatcham Health Centre occupies a purpose built premises of two storeys. It was first opened in the early 1970’s and has been subject to two building extensions since. There is a pharmacy located in the same building and the Citizens Advice Bureau occupies an office within the centre. The practice is located on a main bus route. Car parking is available in a public car park next to the practice. The practice provides disabled parking spaces. All consulting and treatment rooms are located on the ground floor.

Approximately 18,500 patients are registered with the practice making it the largest practice in the Newbury and District Clinical Commissioning Group (CCG). (A CCG is a group of general practices that work together to plan and design local health services in England. They do this by 'commissioning' or buying health and care services). The age profile of the registered population is similar to the average profile for GP practices in England. However, there are slightly higher numbers of those aged under ten and in the 40 to 44 years old age groups. There is minimal incidence of income deprivation among the registered population and the practice recognizes the locations in the area where income deprivation is an issue. Services are delivered via a General Medical Services (GMS) contract. (A GMS contract is a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract).

There are 11 GPs working at the practice. Because some of the GPs work part time, the total whole time number of GPs is just over eight. Seven of the GPs are partners (two male and five female), there are two salaried GPs and two locum GPs. The practice has been advertising for another GP since February 2015 without success.

The practice had experienced a year when three partners were absent either due to sickness or maternity leave and recruiting appropriate levels of GP cover had proven difficult. There are 12 practice nurses. Five of the nurses have an additional qualification enabling them to prescribe a specific range of medicines. The nursing team is completed by three health care assistants and a phlebotomist. The practice manager is supported by a team of three senior staff, three medical secretaries, 11 receptionists and eight administration staff.

The practice has opted out of providing out of hours services to their patients. Out of hours services are provided by Westcall. The out of hours service is accessed by calling 111. There are arrangements in place for services to be provided when the surgery is closed and these are displayed at the practice and in the practice information leaflet.

All services are provided from: Thatcham Health Centre, Bath Road, Thatcham, Berkshire, RG18 3HD.

The practice is a training practice offering three placements for qualified doctors seeking to become GPs.

The practice is open between 8am and 6.30pm Monday to Friday. Appointments are from 8am to 12pm every morning and 2.30pm to 5.30pm daily. Extended surgery hours are offered between Monday and Thursday up to 7pm. The practice is also open on 23 Saturday mornings each year between 8am and 12pm.

Updated 21 December 2016

Letter from the Chief Inspector of General Practice

We carried out a desktop inspection of Thatcham Health Centre on 10 October 2016. We requested information from the practice to be sent to us so we could undertake a review of evidence offsite. This was following an announced comprehensive inspection in February 2016 in which the practice was rated as good for providing safe, effective, caring and well-led services and requires improvement for providing responsive services. This is because we identified concerns with the continuity of care as well as telephone accessibility for patients. We issued a requirement notice and rated the practice as requires improvement in the responsive domain. The practice sent us an action plan stating what they were going to do to make improvements. At this inspection we found:

• Patient access had improved through the introduction of a new telephone system.
• A new appointment system was introduced to help improve continuity of care.

During the previous inspection, we also reported on areas where improvements should be considered. At this inspection we found that the practice had also acted on these findings.

The practice had updated their carers identification protocal. This laid out what information was available within the practice to encourage carers to register and also what steps practice staff could take in order to refer them onto the carers register.

The areas where the provider should make improvement are:

• Ensuring all patients who are carers are encouraged to register as such. Thus enabling the practice to offer the additional support available for this group of patients.
• Continue to make improvements to telephone access to patients who need to book appointments.
• Continue to review appointment systems to respond to patient concerns about continuity of care.

This report only covers our findings in relation to these requirements. You can read the report from out last comprehensive inspection by selecting the ‘all reports’ link for Thatcham Health Centre on our website www.cqc.org.uk 

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 15 April 2016

The practice is rated as good for the care of people with long-term conditions.

• Performance for diabetes related indicators was 80% which was below the CCG average of 86% and national average of 89%.

• Performance for Asthma indicators was 93% which was below the CCG average of 95% and the national average of 97%.

• The practice had excepted 13% of patients with long term conditions from monitoring compared to a national average of 9%.

There were, however, examples of good practice.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. The practice had identified over 2% of patients at risk of hospital admission and care plans were in place for this group

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and were offered a structured annual review to check their health and medicines 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 15 April 2016

The practice is rated as good for the care of families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young patients who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.

• Patients told us that children and young patients were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• The practice’s uptake for the cervical screening programme was 92%, which was above the CCG average of 77%% and the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives and health visitors.

Updated 15 April 2016

The practice is rated as good for the care of older people. 

• The practice offered proactive, personalised care to meet the needs of the older patients in its population.

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

• The percentage of patients aged 65 or over who received a seasonal flu vaccination was better than the CCG and national averages.

• Longer appointments and home visits were available for older people when needed.

• There were over 200 patients registered with the practice who were living in care homes. GPs visited the larger care homes once each week and worked closely with community specialists in care of the elderly.

Updated 15 April 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• Patient feedback showed that telephone access to the practice for booking appointments was proving difficult. Patients told us that having to call at 8am for appointments, and being kept waiting for the call to be answered, was awkward when preparing to go to work.

• Patient feedback in the national survey showed the practice below average for patients being able to access their GP of choice. The practice result was 49% compared to the CCG average of 69% and national average of 59%.

There were, however, examples of good practice.

• The practice offered evening appointments on four days a week and Saturday extended hours clinics were held on 23 occasions each year.

• The practice was proactive in offering online services.

Updated 15 April 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• The practice had identified 1.5% of their registered patients as living with dementia. Of these patients 85% had received a face to face review of their care.

• Practice nurses visited patients living with dementia in their own homes to undertake their care reviews and if they needed any additional care and support.

• The practice had achieved 100% of the national indicators for care of patients experiencing poor mental health and for those diagnosed with depression.

• The GPs provided medical support for two care homes for older patients with mental health problems. There was regular liaison with the community outreach dementia nurse and the old age community mental health team to coordinate the care for these patients.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.

• The practice carried out advance care planning for patients living with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 15 April 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability. Data showed 41 out of 47 of these patients had received an annual health check.

However,

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• 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.

• The practice had formally identified 0.8% of patients as having caring responsibilities.