Archived: Extended Access Clinic at Thamesmead Health Centre

Updated 26 April 2019

The provider, Greenwich Health Team, is a healthcare federation created by four GP practice groups. Membership includes every GP practice in Greenwich and provides healthcare services to nearly 300,000 residents. Working with Greenwich Clinical Commissioning Group (CCG) they provide two GP extended access clinics in the Royal Borough of Greenwich (we have reported separately on the Extended Access Clinic at Eltham Community Hospital). The extended access clinics support primary care services by enabling patients to obtain a pre-booked appointment outside of their own practice’s core opening hours. The clinic includes a wound dressing service provided by local Greenwich nurses.

The service was launched in October 2016. Appointments can be booked through a patient’s GP practice or the NHS 111 service. Appointments are available seven days a week, 4-8pm Monday to Friday and 8am-8pm at weekends. The service offers 234 additional GP appointments per week. The service does not accommodate walk-in patients. GPs are sourced from local practices. However, the service is registered with a locum agency to cover absences.

The Extended Access Clinic at Thamesmead is registered to provide two regulated activities: Diagnostic and screening procedures and Treatment of disease, disorder or injury.

The service is located at:

Thamesmead Health Centre

4-5 Thames Reach

Thamesmead

London

SE28 0NY

The team comprises 41 active local GPs, nurses, 15 receptionists, four central general health team members, and four clinical directors.

The population served by the service rated four on the deprivation measurement scale; the deprivation scale goes from one to 10, with one being the most deprived. People living in more deprived areas tend to have a greater need for health services. The Royal Borough of Greenwich’s Profile of Greenwich residents describes the areas ethnicity as being 52% white British, 9.8% Asian, 19% black, and 4.8% mixed and 8.5% other non-white ethnicities.

In 2018 the provider launched four diabetic services within Greenwich, to support patients to manage their diabetes more effectively. The provider also launched Live Well Centres providing long-acting reversible contraception, NHS health checks and stop smoking services. The services are accessible to Greenwich residents through referral by a patient’s GP or through one of the extended access clinics. This report also covers the delivery of the diabetic services.

Updated 26 April 2019

This service is rated as Good overall.

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

We carried out an announced comprehensive inspection at the Extended Access Clinic at Thamesmead Health Centre on 13 and 14 February 2019 as part of our inspection programme.

This was a first rated inspection for the service that was registered with CQC in September 2016. Our inspection included a visit to the service’s headquarters and also to its operational location.

At this inspection we found:

• The service had good systems to manage risk so that safety incidents were less likely to happen. When they did happen, the service learned from them and improved their processes.
• The provider routinely reviewed the effectiveness and appropriateness of the care provided.
• Care and treatment was delivered according to evidence-based guidelines.
• Staff involved and treated people with compassion, kindness, dignity and respect. The service was acutely aware of the sensitivities around patient confidentiality, and this was taken seriously, with associated policies in place.
• Patients were able to access care and treatment from the service within an appropriate timescale for their needs. The provider had submitted a proposal to implement a direct line to enable patients to book appointments directly.
• There was a strong focus on continuous learning and improvement at all levels of the organisation. The service ran a leadership course to encourage staff development.
• Leaders had an inspiring shared purpose and strove to deliver and motivate staff to succeed. There was strong collaboration, team-working, and support across all functions and a common focus on improving the quality and sustainability of care and people’s experiences.
• Feedback from patients was positive. There was a strong, visible person-centred culture. Staff highly motivated and inspired to offer care that was kind and promoted people’s dignity.
• Multidisciplinary working was at the forefront of the model of care for the service. The provider had on average fourteen internal and stakeholder meetings per month; all were attended by either one of the four directors or a member of the leadership team.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care