Noakbridge Medical Centre

Updated 11 September 2017

The Noakbridge Medical Centre is situated in a residential area of Basildon. There is patient parking facilities and street parking nearby. The practice has approximately 3,999 patients registered with the practice.

• The practice operates from a single location: Bridge Street, Basildon, Essex, SS15 4EZ

• Services provided include: minor surgery, a range of clinics for long term conditions, health promotion and screening, family planning and midwifery.
• At the time of inspection, the practice had one male GP partner and one female salaried GP.
• There was one full time female practice nurse and one off site pharmacist.
• The non-clinical team comprises of a practice manager who was also a partner at the practice, reception and administrative staff.

• The practice opens between 8am and 6.30pm on Mondays to Fridays, extended hours are offered on Tuesdays 8am to 7.30pm. Appointments are offered from 9am to 1pm daily and from 3pm to 6pm on Mondays to Fridays.
• Appointments may be booked two weeks in advance and on the day from 8am. Patients are also able to book appointments with GPs, practice nurses or a healthcare assistant at the local GP Hub service operating from 6.30pm to 8pm Monday to Friday and 8am to 8pm on Saturdays and Sundays.
• Out of hours care is provided by IC24, another healthcare provider. This can be accessed by patients dialling the practice or 111.
• The practice has a comprehensive website providing information on opening times, appointments, services, staff and patient group information.
• They serve a broad demographic with high levels of deprivation amongst children and older people.

Updated 11 September 2017

Letter from the Chief Inspector of General Practice

We first carried out a comprehensive inspection at Noakbridge Medical Centre on 6 July 2016. The overall rating for the practice was requires improvement. The practice was requires improvement for providing safe, responsive and well-led services and good for providing effective and caring services. As a result, the practice was issued with a requirement notice for good governance.

The full report for the July 2016 inspection can be found by selecting the ‘all reports’ link for Noakbridge Medical Centre on our website at www.cqc.org.uk.

At our 7 August 2017 comprehensive inspection we found the practice had addressed all concerns highlighted from the previous inspection and improvements had been made. Overall the practice is now rated as good.

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

• There was an effective system in place for reporting and recording significant events. Staff confirmed discussions had been held and lessons learnt. We found evidence to demonstrate how learning had been shared and changes embedded into practice.
• Patient safety and medicine alerts had been appropriately responded to and revisited.
• All practice policies and protocols were practice specific, updated and reviewed including their significant events policy, infection prevention procedures and legionella risk assessment.
• Clinical audits demonstrated quality improvement, evidence of analysis had been seen and new methods implemented. We found the practice had revisited audits in line with national guidelines.
• The practice had reviewed their national GP survey July 2017 results and were implementing action plans to address the telephone issues that were raised.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Children or vulnerable adults who failed to attend hospital appointments were followed up appropriately.
• Recruitment records were maintained for all staff.
• There was a clear leadership structure and staff felt supported by management. The practice held regular staff and clinical meetings which were documented and available for all staff to view.
• Information about how to complain was available and easy to understand. Complaints were responded to at the time of reporting where possible. Learning from complaints was shared with staff at clinical meetings and an annual review of complaints was conducted.
• All staff had received a Disclosure and Barring Service (DBS) check and an appraisal within the last 12 months.
• We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.
• We found that staff had a clear understanding of key issues such as safeguarding, Mental Capacity Act and consent.
• The practice had identified 35 patients as a carer which was approximately 0.8% of their patient list.
• The practice had a clear vision and strategy which staff understood and strived towards.

The areas where the practice should make improvements are as follows:

• Continue to improve the process for the identification of carers.
• Continue to monitor and ensure improvement to national GP patient survey results.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 11 September 2017

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

• Chronic disease management and patients at risk of hospital admission were identified as a priority.
• The practice had a high QOF achievement in the assessment and delivery of interventions for the management of chronic diseases.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and 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 the practice nurse and relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 11 September 2017

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 people who had a high number of A&E attendances.
• The practice participated in child health surveillance and immunisation rates were high for all standard childhood immunisations.
• The practice’s uptake for the cervical screening programme for 25 - 64year old women was 78%, which was better than the CCG average of 75% and the national average of 73%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 11 September 2017

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 people in its population.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice worked in partnership with the care coordinator team provided by the clinical commissioning group (CCG) to ensure patients identified at risk were contacted regularly and upon discharge from hospital.
• The practice worked closely with their admission avoidance patients and allowed them access through a priority telephone number.
• The practice offered shingles and pneumococcal vaccinations to patients.

Updated 11 September 2017

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

• Routine pre-bookable weekend appointments were available to all patients.
• The practice offered online services as well as a full range of health promotion and screening that reflected the needs for this age group such as smoking cessation.
• The practice offered a travel vaccination service including being a yellow fever vaccination centre.
• The practice offered a range of clinical interventions including minor surgery incisions, excisions and joint injections
• A full range of health promotion and screening services were available to patients. For example, over 40 years of age health checks, cholesterol and blood pressure checks and cardiovascular risk checks.

Updated 11 September 2017

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

• The practice’s data showed that 78% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the CCG average of 83% and the national average of 84%
• The practice was higher than the CCG average of 86% and the national average of 89% for their management of patients with poor mental health. For example, 97% of their patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive care plan documented in their records within the last 12 months.
• The practice multi-disciplinary team meetings had been less frequent due to staff shortages in other teams however the practice had still conducted a review of their patients at clinical meetings to manage patients experiencing poor mental health, including those with dementia.
• The practice carried out advanced care planning for patients with dementia and provided home visits for those unable to attend the practice.
• 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.
• Patients and their family members were offered longer appointments to discuss concerns. Carers were highlighted on their patient record and offered appropriate vaccinations and health checks.

Updated 11 September 2017

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.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with other health care professionals 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 identified patients in sheltered accommodation and had hosted events for them to gather and feel part of the community.