Bradford Care Alliance CIC Also known as Bradford Care Alliance CIC Ltd

Updated 12 September 2022

Bradford Care Alliance CIC is a community interest, general practice membership organisation which was established in 2016 and registered with the Care Quality Commission in April 2017. The registered location is The Ridge Medical Centre, Cousen Road, Bradford, BD7 3JX.

Bradford Care Alliance CIC (BCA) is made up of 55 practices which incorporates 9 Primary Care Networks (PCNs) providing services in the Bradford area, covering an approximate population of 470,000 patients.

BCA is the extended access and extended hours contract holder for the Bradford based PCNs for NHS West Yorkshire Integrated Care Board which was formerly Bradford District and Craven Clinical Commissioning Group. This report refers to this joint provision as extended access.

In 2018 the CCG also commissioned BCA to provide a primary care streaming service in the emergency department of the local hospital. Both of these services were reviewed as part of our inspection.

BCA subcontract staff from a number of different providers. They contract directly with the registered providers of the hub locations for use of their premises.

Bradford Care Alliance CIC, also sub-contract directly with voluntary care sector services who provide mental health triage and support appointments and young people’s counselling appointments. We have not inspected these services, as under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, these services do not fall under the Care Quality Commission’s scope of registration.

The provider location and administrative centre operates from Scorex House, 1 Bolton Road, Bradford, BD1 4AS. The organisation is led by a Chair who is supported by the CQC Registered Manager, the Corporate Director, a Strategic Director, Medical Director, Clinical Director and a Chief Operating Officer. There is also a lay member of the board. Changes to the board were being made at the time of our inspection.

Bradford Care Alliance CIC is registered to deliver the regulated activities:

• Treatment of disease, disorder or injury

• Diagnostic and screening procedures.

Patient care for the extended access service is delivered from eight locations (hubs) in the district,

• The Ridge Medical Practice, Cousen Road, Bradford, BD7 3JX
• Shipley Medical Practice, Alexandra Road, Shipley, BD18 3EG
• Picton Medical Centre, 50 Heaton Road, Manningham, Bradford, BD8 8RA
• Bowling Highfield Medical Practice, Bowling Hall, Rooley Lane, Bradford BD4 7SS
• Moorside Surgery, 370 Dudley Hill Road, Eccleshill, Bradford BD2 3AA
• Park Grange Medical Centre, 141 Woodhead Road, Bradford BD7 2BL
• Bingley Medical Practice, Canalside Health Care Centre, 2 Kingsway, Bingley BD16 4RP
• New Otley Road Medical Practice, Hillside Bridge Health Centre, 4 Butler St W, Bradford BD3 0BS.

The primary care streaming service (PCSS) offers support to patients who attend the emergency department located within the Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ. Patients are reviewed on arrival in the emergency department and triaged as suitable to be seen by a GP, further assessment is then conducted, and patients are directed to the primary care streaming service. Where appropriate and throughout the report the PCSS will be included in any reference to a hub site.

During this inspection we visited the PCSS at the Bradford Royal Infirmary, and three hub sites located at Moorside Surgery, Bingley Medical Practice and The Ridge Medical Practice.

Extended access appointments are available at various sites throughout the week between 6:30pm and 9:30pm. Weekend appointments are offered from Picton medical Centre 9am and 5pm on a Saturday and between 10am and 2pm on a Sunday. On weekdays patients can access:

• Telephone and face to face GP consultations

• Blood tests (phlebotomy) for patients aged 16 years and above

• Cervical screening appointments

• Physiotherapy first for patients aged 16 years and above

GP appointments are offered over the weekend and a phlebotomy service is offered for half a day on a Saturday.

Appointments at the PCSS are available from 12 noon to 12 midnight, seven days per week, 365 days a year.

The extended access service at all locations is provided by a number of GPs, nursing staff, healthcare assistants, physiotherapists and a range of voluntary care sector practitioners. Some staff work at multiple sites and some at one site. Two reception staff are located at each of the patient facing sites during operational hours.

Bradford is a young, diverse city and there are high levels of deprivation within the area. Above average numbers of patients present with heart disease, mental health issues and some long-term conditions. For example, 33,280 patients have been diagnosed with diabetes by their GP.

Participating practices are allocated a pro-rata allowance for appointments, per 1,000 patients per week and this is closely monitored. There are parking facilities at all sites. All hub locations are accessible by public transport and can be easily accessed by patients with limited mobility.

Updated 12 September 2022

This service is rated as Good overall. (Previous inspection 29 June 2021- Requires Improvement)

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 of Bradford Care Alliance CIC between the 8 and 10 August 2022. This inspection was carried out to review the breach of regulations and the concerns identified at the inspection on 29 June 2021.

At this inspection we found:

At the previous inspection in June 2021 we rated the provider as requires improvement overall and requires improvement for providing safe, effective and well-led services. We rated the provider as good for providing caring and responsive services. At this inspection we found the provider had responded to our concerns and made significant improvements following our last inspection.

For example:

• The provider had developed processes to maintain oversight of the hub sites. Systems were in place to ensure that premises and equipment were safe.
• The provider had implemented effective processes to manage the recruitment and training of staff.
• The provider had reviewed their systems to manage risk and respond to concerns and complaints. When incidents did happen, the provider learned from them and improved their processes. This information was shared with staff via bulletins and regular emails.
• Patients reported that they were able to access care when they needed it. Feedback from patients regarding the services provided was positive.
• The practice operated effectively to ensure good governance in accordance with the fundamental standards of care.
• Staff told us they enjoyed working for the provider and were kept up to date with information and changes to the service.

We saw one area of outstanding practice:

The service was commissioned to provide the primary care streaming service (PCSS) offered at the local hospital. We found strong, professional and reciprocal relationships between the team and the staff working within the emergency department (ED) which kept patients safe. Safety netting arrangements were in place for patients when they presented and when they moved between the PCSS and the ED. Continual assessment of the patients needs was in place and regular communication and attendance at afternoon ED ‘huddles’ (short meetings to review patient flow, presentation, staffing and safety) gave a clear clinical picture of any challenges or issues. An oversight of quality and safety was in place and embedded into the team.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services