Laindon Medical Group

Updated 28 January 2016

Dr R B Marshall and Partners is also referred to as Laindon Health Centre. The practice shares the centre with another GP practice, a dentist and community health services (health visitors, mental health service with injection clinics for psychotic patients, podiatry, retinal diabetic screening, leg ulcer clinics and counselling services). The administrative and nursing team are jointly employed by Dr R B Marshall and Partners and the other GP practice in the building with both practices sharing the waiting and treatment rooms.

Dr R B Marshall and Partners, consist of six partners and a salaried GP providing nine clinical sessions a week. There are five female GPs and four male GPs, including two Registrars. The practice shares their administrative and nursing team with their neighbouring practice. The nursing team consists of six practice nurses, two healthcare assistants and a care coordinator. The clinical teams are supported by receptionists, administrative staff overseen by a practice manager.

It is a training practice aligned to the Eastern Deanery and has two Registrars. GP Registrars are qualified doctors who are in training to become a GP through a period of working and training in a particular practice. They will usually have spent at least two years working in a hospital before you see them in a practice and are closely supervised by a senior GP or trainer.

The practice has a patient population of approximately 13179. It serves a deprived community and Basildon, in which it is situated, has the highest under 18 year old conception rate in Essex.

The practice is open between 8am to 7.15pm Monday to Thursday, Friday 8am to 6.30pm and Saturday 8.45am to 12.45pm. Appointments are from 8.50am to 12.30pm and 3pm to 5.30pm Monday to Friday. Saturdays the practice is open from 9am to 12noon. Extended hours surgeries are provided 6.30pm to 7.10pm Monday to Thursday. Saturday openings is from 8.45am to 12.45 with consultation times from 9am to 12noon. These were for routine bookable appointments. The practice offers on line appointments and on line ordering of repeat prescriptions. Patients can request an on the day telephone consultation with a GP and/or nurse. In addition to pre-bookable appointments that can be booked up to six weeks in advance, urgent appointments are also available for people that needed them.

When the practice is closed patients are advised to call the surgery and be directed. Alternatively they may call the national NHS 111 service for advice. Out of hours provision is commissioned by Basildon and Brentwood CCG, and provided by IC24.

The practice has a comprehensive website providing details of services and support agencies patient may find useful to access.

Updated 28 January 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr R B Marshall and Partners on Wednesday 16 December 2015. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording all events and reviewed to identify those which were significant events and ensure learning was identified, shared and embedded.
• Risks to patients were assessed and well managed.
• The practice was visibly clean and tidy, infection prevention control audits had been conducted and staff had training and guidance to maintain safe standards of care.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. The practice acknowledged and accommodated individual’s needs in how it delivered care.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment face to face or over the phone with a GP, there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice were passionate and adopted reflective practice, listening to staff, patients and considering clinical best practice, identifying potential learning and amending practices to improve outcomes for their patients.
• There was a clear leadership structure, with documented business plans shared with the staff. Staff felt supported by management and enjoyed their work.

Professor Steve Field

(CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 January 2016

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

• The practice employed recall systems for chronic disease informed by national guidance.
• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.
• Rescue packs for asthma and COPD patients were employed mitigating the risks of patients requiring emergency admission to hospitals
• The practice promoted and provided diagnostic equipment to assist patients to self-monitor their conditions.

Updated 28 January 2016

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.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• Patients had open access to childhood immunisations. Immunisation rates were high for all standard childhood immunisations.
• The practice combined checked to enhance convenience for both mother and child conducting immunisations, eight week baby checks and postnatal care.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 28 January 2016

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. This was achieved through the involvement of partner services including the practice care coordinator.
• The practice conducted regular multidisciplinary meets and care planning.
• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice operated a bypass telephone access service for care homes and paramedics.

Updated 28 January 2016

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

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care offering early morning, evening and Saturday morning appointments and telephone consultations on the day.
• The practice was proactive in offering online services for appointments and prescriptions as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 28 January 2016

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

• 87.67% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months. This was higher than the national average and they operated a recall system for patients who failed to attend.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• The practice had produced additional guidance for patients to assist carers for patients with dementia and poor mental health.
• It told patients experiencing poor mental health about how to access various support groups and voluntary organisations including providing open access to talking therapies.
• It carried out advance care planning for patients with dementia.
• It 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 people with mental health needs and dementia and worked closely with the practice care coordinator to meet the patient’s holistic needs.

Updated 28 January 2016

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 homeless people and those with a learning disability. The practice permitted their address to be used by patients with no fixed abode to access services and welfare benefits, and their facilities for accessing clean water and washing.
• It offered flexible and longer appointments for people where there was a need and weekly prescribing for patients at risk of inappropriate medication use.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people and had care plans for over 2% of their most vulnerable patients.
• It had told 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.