Archived: Extra Care Central Gateshead Also known as Community Based Care Health Limited

Updated 10 October 2019

Newcastle & Gateshead CCG has commissioned the provider (Community Based Care (CBC) Health Ltd) to provide additional appointments with GPs and nurses outside of normal GP practice hours at two extended access facilities (Extra Care Blaydon and Extra Care Central Gateshead). CBC Health Ltd. was founded in 2006 as a not-for-profit member organisation.

The extra care services offer 15-minute pre-bookable, routine primary care appointments with a range of clinicians including GPs and nurses to patients already registered with any of the 30 GP practices in the Gateshead area (total patient population 222,000). They do not offer appointments for:

• Patients with long term conditions, or chronic diseases, where the reason for the appointment is directly related to their condition should be booked into the service;
• Patients with complex mental health issues, where the reason for the appointment is directly related to their condition;
• Cases of alcohol or substance misuse;
• Patients who require a sick note;
• Repeat medication requests;
• Patients who might require an onward referral;
• Patients who have not agreed to “data sharing”;
• Patients who are known to be aggressive/violent;
• Nurse appointments for patients under 18 years of age;
• Patients on maggot therapy.

The services operate from 8am to 8pm on a Monday to Friday and from 9am to 2pm on a Saturday and Sunday. To book an appointment the patient must first contact their own GP practice. Receptionists will then consider whether an appointment at an extra care facility is appropriate based on guidance and criteria issued by the provider. Walk-in appointments are not available and patients cannot book directly with the extra care services. When patients attend the extra care facilities for an appointment they are asked for consent to access their patient record.

All administration and support functions are delivered by a bank of non-clinical staff employed by CBC Health who work at the two GP practices from where the extra care services are delivered (Blaydon GP Led Surgery and Central Gateshead Medical Group).

CBC Health also holds the contracts for several GP practices in the Gateshead area (Crawcrook Medical Centre, Rowlands Gill Medical Centre, Blaydon GP Led Surgery, Grange Road Medical Practice) as well as the contract for the local out of hours service (Gatdoc). In addition, they:

• Provide back office support to a number of GP practices (including HR functions, health and safety and long-term condition recalls) under their ‘bureau’;
• Provide pharmacy support to the majority of GP practices in the Gateshead area to aid medicines optimisations under their ‘Pharmicus’ arm;
• Run the local GP federation.

Updated 10 October 2019

We carried out an announced focused inspection at Extra Care Central Gateshead on 23 August 2019. This was to check the practice had made the improvements we said they should, when we last inspected the practice in October 2018.

At the last inspection, we rated the practice as requires improvement for providing safe services. We said the provider should:

• Strengthen the arrangements to alert a patient’s own GP when a patient requires further investigation or referral to another service.
• Embed the information governance requirements for clinical staff into induction and information/guidance packs.
• Continue with plans to develop a more formal and effective channel of communication and engagement with clinical staff which includes dissemination of learning from complaints, significant events and clinical audits as well as implementation of best practice guidance.

At this inspection, we found that the provider had acted to address these areas.

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 rated this practice as good overall. (Previous rating October 2018 – Good).

We rated the practice as good for providing safe services because the practice had:

• Put a new policy was in place regarding the dissemination of information relating to referrals. Practices were now telephoned to inform them that their patients had been referred. We saw discharge summaries that had been sent to practices after patients had visited the service and these also included details of any referrals made;
• Put note on the service’s computer system which appeared when staff logged in to remind them of information governance requirements. We saw that the same information was also included in the staff induction pack. Staff had also completed information governance training since the last inspection;
• Put a system in place so that learning from matters such as significant events, complaints or clinical audit was shared with clinical staff via emails and the staff newsletter.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care