East Norfolk Medical Practice is the provider registered with CQC. Nelson Medical Centre is a location registered with that provider.
We carried out an announced comprehensive inspection on 23 October 2019 as part of our inspection programme. Our inspection team was led by a CQC inspector and included a GP specialist advisor and a CQC inspection manager.
We based our judgement of the quality of care at this service on a combination of:
- what we found when we inspected
- information from our ongoing monitoring of data about services and
- information from the provider, patients, the public and other organisations.
We have rated this practice as good overall.
We rated the practice as requires improvement for providing caring services. The population group of working age people (including those recently retired and students) was also rated as requires improvement.
- GP survey data was lower for all indicators relating to patients’ experience during consultations.
- The practice was aware their cancer screening uptake rates including cervical screening rate was significantly lower than the national average. They had reviewed performance in relation to cancer screening and reviews and were in the process of inviting patients in for appointments.
We found that:
- Systems and processes to safeguard patients from abuse were embedded and appropriate.
- Patients received effective care and treatment that met their needs.
- Staff dealt with patients with kindness and respect and involved them in decisions about their care.
- The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
- The way the practice was led and managed promoted the delivery of high-quality, person-centred care.
The population group for people whose circumstances make them vulnerable is rated as outstanding because;
- The practice had a homeless care service, which included an outreach service at the Salvation Army hall, street work and participated in the multi-disciplinary team working from the local housing trust base. Services included immediate access for homeless patients.
- The practice demonstrated that they had a system to identify people who misused substances and treated them in a discrete and respectful way. The provider was able to demonstrate the impact of their scheme in successful dependence reduction. The practice hosted an in-house drug and alcohol service which included a clinic to manage patients with drug seeking behaviour.
- The practice had employed a life coordinator who had helped homeless patients get rehoused.
- The practice had implemented a multi-disciplinary team called the High Intensity User Group to review patients that required the use of the service more frequently. This included homeless patients, patients that have complex social needs and patients enrolled in the misused substance reduction scheme.
Whilst we found no breaches of regulations, the provider should:
- Continue to monitor and act on health and safety ensuring information can be obtained at location level.
- Continue to review and encourage uptake on national screening programmes and childhood immunisations.
- Continue to engage with patients, review and improve patient satisfaction in relation to access and patients experience during consultations.
- Continue to review the action plan and embed the identified changes to improve outcomes for patients in relation to the Quality and Outcomes Framework, particularly in relation to exception reporting relating to diabetes, COPD and mental health.
- Ensure location specific significant events are recorded and kept at location level.
- Ensure the staff immunisation policy is implemented.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care