Ariel Healthcare Also known as Essex House Medical Centre

Updated 13 February 2018

Essex House Surgery is located at 59 Fore St, Chard, Somerset, TA20 1QA. The service had approximately 8,787 patients registered from around the local and surrounding areas. Patients can access information about the service at www.essexhousemedicalcentre.org.uk

The service is located on a main thoroughfare in the centre of Chard. There is a small car park and disabled parking bays to the rear of the building. Further parking is a short walk away in a public car park. The front of the building, Grade two listed, has been adapted where possible to meet the needs of the service. To the rear is a purpose built extension that provides adequate consulting and treatment areas on the ground floor that is accessible to patients with limited mobility.

The practice partnership consists of four GP partners who employ one salaried GP. There are two male and three female GPs. The practice employed two nurse practitioners, four practice nurses and three health care assistants. The practice has a practice manager who is supported by a team of management staff, reception staff, administrators and secretaries.

The practice is open from 8.00am Monday to Friday until 6.30pm. Extended hours until 8pm are available on alternate Wednesday and Thursday evenings. In addition, working in conjunction with other practices in the area they open in the evening for nine Fridays per year until 8pm and nine Saturday mornings from 8.30am to 11.00 am per year. Patients have the option of attending late evening and Saturday morning surgeries at other local practices who are participating in a Somerset Clinical Commissioning Group, Improved Access Pilot Scheme.

The practice has a General Medical Services (GMS) contract with NHS England (a locally agreed contract negotiated between NHS England and the practice). The practice is contracted to deliver a number of enhanced services including; extended hours access for patients, childhood immunisations, enhanced services for the assessment and provision of services for patients living with dementia and minor surgery.

The practice does not provide out of hours services to its patients, this is provided via NHS111 Contact information for this service is available in the practice and on the practice website.

Demographic data from 2015/2016 that is available to the CQC shows:

The age of the patient population was similar to the national averages for patients under the age of 18 years at 18%, the national average being 20%. For patients over 65 years the practice has 25% with the national average being 17%.

Other Population Demographics included 60% of the practice population had a long standing health condition, which was above the national average of 54%. Also 54% of patients were in paid work or full time education which was below the national average of 62%. Information from the

Index of Multiple Deprivation 2015 (IMD): showed the practice population is at 20 (the national average 21). The lower the number the more affluent the general population in the area is.

Income Deprivation Affecting Children (IDACI): is 16% (the national average 20%)

Income Deprivation Affecting Older People (IDAOPI): is 13% (the national average 17%).

Updated 13 February 2018

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection 26/11/2014 – was overall rated as Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive at Dr Wilcox & Partners at Essex House Surgery on 20 December 2017. This inspection was carried out as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.

• Staff involved and treated patients with compassion, kindness, dignity and respect.

• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

• There was a focus on continuous learning and improvement within the practice. For example, improved guidelines for clinical staff in regard to medicines management which was shared across to other GP services in the federation.

• The practice has set aside a ‘safe’ area with telephone access and information for vulnerable people to have access to seek support from external organisations. Such as help for domestic abuse.

• The regular multi-disciplinary meetings held with the Health Visitor, Midwife and School Nurse team have been recognised as best practice by the Somerset Clinical Commissioning Group Safeguarding Nurse.

• The practice at the time of the inspection had on-going IT issues which had impacted upon the speed and flexibility of using patient records, templates and IT work streams. Support had been sought from the providers of the IT systems and the practice were still awaiting them to be resolved. Although challenging for the staff, they had implemented workarounds to ensure that patients care and support was not compromised.

There was an area that was outstanding:

• The practice had been recognised for its work in monitoring high risk medications as it was one of five GP practices from across the country nominated for the National Prescribing Safety Awards 2017.

The areas where the provider should make improvements are:

• The practice had detailed information of the recruitment and selection process although they should consider recording the identity of the members of staff conducting the interview and selection process to aid a good audit trail.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 13 February 2018

Updated 13 February 2018

Updated 13 February 2018

Updated 13 February 2018

Updated 13 February 2018

Updated 13 February 2018