Archived: The Village Medical Centre

Updated 3 August 2018

The Village Medical Centre is a GP practice currently being managed by NHSolutions Ltd under a caretaking agreement with NHS England and the local commissioners. The practice holds an Alternative Personal Medical Services provisions (APMS) contract with NHS England in a caretaker role (caretakers are utilised when a contract has been returned and the long-term contract has not yet been awarded to a successful applicant).

The Village Medical Centre provides a range of primary medical services to the residents of the Great Denham and the surrounding areas. The provider NHSolutions Ltd also deliver services in a number of other locations in England. At the time of inspection, the practice had approximately 8,070 patients consisting primarily of white British patients, with higher than average numbers of patients between the ages of 30 to 50 years.

National data indicates that the area does not have significant levels of deprivation. The clinical team consists of a lead GP (male) who is supported by two regular locum GPs (male) and a long-term locum advanced nurse practitioner (ANP) (female). In addition there is a lead nurse trained in minor illness(female), three practice nurses (female) and a health care assistant (female). The clinical team is supported by the operations manager, the practice manager, health secretaries and a team of administrative staff.

The practice is open from 8am to 6.30pm Monday to Friday. Appointments are available from 8.30am to 11.45am and from 2pm to 6pm Monday to Friday. The practice offers a variety of access routes including telephone appointments, on the day appointments, home visits and advance pre-bookable appointments. When the practice is closed out of hours services are provided by the Herts Urgent Care and they are accessed via the NHS 111 service.

Updated 3 August 2018

This practice 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 Village Medical Centre on 20 June 2018 as part of our regulatory purposes.

At this inspection we found:

• The practice had good systems to manage risk so that safety incidents were less likely to happen. When incidents did occur, the practice learned from them and improved their processes.
• The practice had a clear process and understanding of safeguarding.
• Although effective monitoring processes were in place, which included health and safety, infection prevention control, training and appraisals. During our inspection the practice was unable to provide evidence to demonstrate that an effective employee immunisation programme was in place. Specifically, evidence was not in place to demonstrate that relevant staff had been immunised against infectious diseases such as measles, mumps and rubella (MMR). All staff were immunised against Hepatitis B.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered in accordance with evidence based guidelines. Support and monitoring was in place for nurse prescribers.
• Staff treated patients with compassion, kindness, dignity and respect. All staff had received equality and diversity training.
• Information on the complaints process was available for patients at the practice and on the practice’s website. There was an effective process for responding to, investigating and learning from complaints.
• Staff had the skills, knowledge and experience to carry out their roles and there was a strong focus on continuous learning and improvement at all levels of the organisation. Staff we spoke with felt supported by the practice.
• The provider was aware of and complied with the requirements of the Duty of Candour.
• Some patients reported difficulties accessing appointments. The practice advised that improvements had been made to improve appointment access. For example, the practice had employed an advanced nurse practitioner to improve appointment access.

• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• We saw evidence of effective implementation and management of change at the practice Improvements were made within a short period of time, which helped to stabilise the practice team following a period of instability and ongoing uncertainty. In particular communication amongst the practice team and other key stakeholders was developed to help drive improvement. The practice shared learning with four other practices that were managed by the provider organisation.

The areas where the provider should make improvements are:

• Ensure that an effective employee immunisation programme is in place so that staff working in general practice receive the immunisations that are appropriate for their role.
• Continue to identify patients who maybe carers in order to offer them support.
• Continue to monitor and assess the suitability and availability of emergency medicines in line with guidance.
• Continue with efforts to improve access to appointments and improve patient satisfaction.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Updated 3 August 2018

Updated 3 August 2018

Updated 3 August 2018

Updated 3 August 2018

Updated 3 August 2018

Updated 3 August 2018