Archived: Old Road Medical Practice

Updated 29 June 2017

Old Road Medical Centre main practice is located in Old Road close to Clacton Town Centre. The branch practice is located at 103 Clacton Road, St Osyth. The practice provides services for approximately 9,520 patients living within the Clacton area. This is an increase of over 2,000 patients in the last two years. Almost 500 have registered from another practice that stopped providing a service to support patients needing medicine addiction and mental health support.

The practice holds a Personal Medical Services (PMS) contract commissioned by NHS England and performance managed by North East Essex Clinical Commissioning Group.

The practice population is similar to the national average for younger people and children under four years, working aged and recently retired and higher for older people aged over 75 years. Economic deprivation levels affecting children, older people and unemployment are amongst the second highest in England. Life expectancy for men (79 years) and women (83 years) are in line the national averages. The patient list size has a higher than national average of patients with long standing health conditions and those of working age who are unemployed.

The practice is managed by two GP partners, both male, who hold financial and managerial responsibility for the practice, and one long term locum GP, female. The practice employs two nurse practitioners, three practice nurses and four health care assistants. There are 15 administrative staff that include; a practice manager, an assistant practice manager, and an office manager to support the clinical teams. The nursing and administrative teams work a variety of full and part time hours.

The main and branch surgery’s opening hours were, on the practice information leaflets, and the practice website. The clinical sessions operated during the opening hours and included clinics for asthma, chronic obstructive pulmonary disease (COPD), diabetes, contraception, smoking cessation, phlebotomy (blood taking), childhood immunisation, holiday vaccinations and late night opening on Thursday evening for working patients.

                               Main Surgery                   Branch Surgery

Monday                  8am - 6:30pm                    11am - 1pm

Tuesday                 8am - 6:30pm                    11am - 1pm

Wednesday           8am - 6:30pm                     11am - 1pm

Thursday               8am - 8:30pm                     11am - 1pm

Friday                    8am - 6:30pm                     11am - 1pm

Weekend closed closed

The practice has opted out of providing GP out of hour’s services. Patients calling the practice outside practice working hours are advised by the answerphone message to contact the 111 non-emergency services. Patients requiring urgent treatment are advised to contact the out of hour’s service provided by Care UK. The branch surgery offers GP on the day appointments each day between 11am and 1pm and pre-booked nurse appointments. This information is also available on the practice website.

We previously carried out inspection at Old Road Surgery on 04 June 2015. The overall rating for the practice was good, however, they were rated requires improvement for effective services. A comprehensive inspection was undertaken in line with our policy as it has been over 12 months since the first inspection.

Updated 29 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Old Road Medical Practice on 04 June 2015. The overall rating for the practice was good; however, they were rated good for safe, caring, responsive and well-led services and requires improvement for effective services. The full comprehensive report on the June 2015 inspection can be found by selecting the ‘all reports’ link for Old Road Surgery on our website at www.cqc.org.uk.

We carried out an announced comprehensive follow-up inspection at Old Road Surgery on 05 May 2017. Overall, the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• Staff members knew how to raise concerns, and report safety incidents.
• Safety information was appropriately recorded; learning was identified and shared with all staff members.
• The infection control policy met current guidance. Audits had been carried out, reviewed, and analysed to monitor infection control.
• Risks to patients and staff members had been assessed, documented and acted on appropriately.
• Staff members assessed and delivered patient care in line with current evidence based guidance.
• Staff had the skills, knowledge, and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and involved in their care and treatment decisions.
• Information about the practice services and how to complain was readily available in English and Polish at the reception desk and the practice website in easy to understand formats.
• The practice was aware of and complied with the requirements of the duty of candour when dealing with complaints and significant events.
• Patients said they were able to make an appointment with a named GP and they received continuity of care. We were also told they had access to urgent appointments on the day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and in addition, staff members felt supported by the GPs and practice management team.
• The practice patient participation Group (PPG) worked proactively with the practice.

The areas where the provider should make improvements are:

• Audits undertaken should be completed cycles, to measure improvement.
• Identify areas of lower patient satisfaction within the GP survey to act on patient satisfaction improvement.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 29 June 2017

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

• Nursing staff and GPs had lead roles in chronic disease management
• Patients at risk of hospital admission were identified as a priority. Personalised care plans ensured continuity of care.
• Diabetic quality data from 2015 to 2016 showed the practice averages were lower at 84% than local and national practices. With the support of a local CCG project to improve diabetic care, the practice unverified data for 2016 to 2017 showed an improvement of diabetes quality to 93%.

Other services provided by the practice for this population group were:

• Longer appointments and home visits when needed.
• People with long-term conditions were provided a named practice GP and a structured annual review to check their needs were met.
• The named GP worked with relevant health and social care professionals to deliver a multidisciplinary package of care, to reduce the need for hospital visits.
• Practice prescribers used clinical templates designed to ensure patients received blood tests and diagnostic checks required, before repeat prescriptions were given to patients.

Updated 29 June 2017

The practice is rated 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 or at risk, for example, those who had a high number of A&E attendances.
• Immunisation rates were higher than local and national practices, for all standard childhood immunisations.
• A range of contraception services was available.
• Cervical screening data showed the practice was comparable with other local and national practices.
• Appointments were available outside of school hours and college hours, and the premises were suitable for children and babies.
• On-line appointments were available for both advanced and on the day appointments.

Updated 29 June 2017

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

• The practice offered personalised care to meet the needs of the older people in its population.
• The practice responded to the needs of older people, and offered home visits and urgent appointments for those that needed them.
• All older people had a named GP.
• Palliative care meetings every six to eight weeks were used to understand and discuss patients identified as frail and at risk of deteriorating health.
• They had a high uptake for shingles and flu vaccinations and actively campaigned across a variety of media, for example; prescription repeat forms, posters in the waiting room, on their website and opportunistically during routine appointments.
• Senior health checks were offered, on an ad hoc basis to maximise their uptake.
• A care advisor visited the practice regularly to help patients deal with benefits queries, help completing forms, and equipment needs.

Updated 29 June 2017

The practice is rated 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 offered.
• The practice offered late appointments on Thursdays until 8.30pm. These were for working patients that who could not attend during normal core practice opening hours.
• They offered online services to book appointments, request repeat prescriptions, and to receive text alerts.
• A full range of health promotion and screening was available at the practice that reflected the needs of this age group.

Updated 29 June 2017

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

• 81% of people diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months; this was comparable with local and national practices.
• The practice regularly worked with multi-disciplinary teams to support patients experiencing poor mental health, and including those with dementia.
• Staff members had received training to help safeguard adults and children from abuse. They were familiar with the details of the Mental Capacity Act.
• The practice employed a consultant psychiatrist to work one afternoon a week. This had been in response to an identified need through analysis of quality data. In addition, a number of patients had recently registered from another practice that was seeking support for addiction and mental health concerns. The practice knew they could not support the increased number of patients from this population group with timely intervention unless they continued with this extra consultant support. The staff had received guidance to direct patients that needed mental health support appropriately.
• The practice had told and supported patients experiencing poor mental health 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.
• Staff members told us they would find a suitable quiet area for patients to wait if they were feeling anxious, depressed, or too unwell to wait in the busy waiting room.

Updated 29 June 2017

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

• The practice recognised patients living in vulnerable circumstances including, homeless people, travellers and those with a learning disability.
• The practice offered longer or double appointments for patients with a learning disability. They had recognised 55 people with a learning disability, each of them had been offered a health review.
• The practice clinical members of staff worked with other health care professionals in the case management of vulnerable patients. They worked closely with local care homes to provide, treatment planning, and home visits when needed.
• Nursing home visits were provided by the GPs and a member of the nursing staff, to ensure regular support for patients.
• They provided information to vulnerable patients about how to access various support groups and voluntary organisations.
• Staff members knew how to recognise the signs of abuse and were aware of their responsibilities concerning the sharing of information regarding safeguarding concerns.
• The practice safeguarding policy set out the details to contact relevant local agencies during normal working, and out of hours.
• All staff members had undergone safeguarding training of vulnerable adults and children.
• The GP safeguarding lead at the practice attended forums when possible.