Mount Chambers Medical Practice

Updated 10 November 2017

The practice is based in the town of Braintree near to the local supermarket. There is very limited parking for the practice so patients are recommended to use the supermarket car park. The nearest train station is Braintree which is a mainline station.

The practice premises are small and they have expanded these slightly by the use of linked porta-cabins whilst they await new premises. At the time of our inspection the practice is open to new patients.

This practice is a teaching and training practice and has medical students, GP registrars in their final stage of training, physician associate trainees and student nurses. GP registrars are fully qualified doctors and have had at least two years of NHS experience. Medical students may sit in on consultations and examinations with the patient’s consent. It is also a dispensing practice, which means that patients who do not have a dispensing chemist within a 1.6km radius of their house can get their prescribed medicines dispensed from here.

The list size of the practice is approximately 13710. The practice has a large staff group, this includes seven GP partners, four male and three female, and one salaried GP. There are two female advanced nurse practitioners (who are able to provide many services a GP can), three female practice nurses and four female health care assistants (HCAs). There is a number of other staff carrying out administrative duties, led by a practice manager. In addition, the practice also has five dispensers, a dispensary manager, three phlebotomists and a seconded pharmacist.

The practice is open between 8am and 6.30pm on Mondays to Fridays. Appointments times vary dependant on the clinical staff seen. Times range from 8.30am to 12.30pm and 3pm to 6pm Monday to Friday for GPs and 8am to 12.30pm and 2.30pm to 6pm for nursing staff.

When the practice is closed patients are advised to call the practice number where they will be redirected to the out of hours service, if they require medical assistance and are unable to wait until the surgery reopens. The out of hour’s service offers either a telephone consultation with an on-call doctor or an appointment at the Emergency Centre. In the case of an emergency, such as chest pains, patients are advised by the practice to dial 999.

The practice has higher than the CCG and national average numbers of 65 to 85+ year olds. There is a higher than average percentage of patients with a long-term health condition. The practice population also has higher than average levels of income deprivation affecting both children and older people.

Updated 10 November 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Mount Chambers Medical Practice on 11 January 2017. The practice was rated as good overall and requires improvement for well-led. The full comprehensive report on the January 2017 inspection can be found by selecting the ‘all reports’ link for Mount Chambers Medical Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 17 October 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 11 January 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as Good.

Our key findings were as follows:

• Prescription stationery was stored in clinical rooms in locked printers.
• The practice had reviewed the outcome of the GP survey, published in July 2017, and used this feedback to improve the service offered to patients.
• Specimens were stored safely prior to submission for testing.
• The practice had file containing information relating to medicine and patient safety alerts and staff were aware of where this was kept.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 April 2017

The provider is rated as good for this population group.

• These patients were offered a structured annual review of their condition.
• The practice ran a monthly ‘self-help’ group for patients with type 2 diabetes, which was also open to patients with this condition in the locality but not registered at the practice.
• Nursing staff had lead roles in chronic disease management.
• The practice performance for diabetes indicators was in line with or above the CCG and national average. For example, the percentage of patients with diabetes with a recent blood pressure reading within specified levels was in line with the CCG and national averages.
• For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

• All patients had a named GP who was responsible for their care.

Updated 18 April 2017

The provider is rated as good for this population group.

• There were systems and processes in place to enable staff to identify and take appropriate action to monitor and safeguard children and young people living in disadvantaged situations.
• Immunisation rates were in line with CCG and national averages for standard childhood immunisations.
• The practice ran baby and post-natal clinics for mothers.

• Weekday appointments were available before and at the end of school hours.

Updated 18 April 2017

The provider is rated as good for this population group.

• The practice pharmacist completed frequent medicines reviews for this group to review patients on poly pharmacy (which is a patient taking four or more medicines at the same time).
• Patients aged over 75 had a named GP.
• The practice worked with relevant health and social care professionals to deliver a multidisciplinary package of care.
• The practice closely monitored older patients who were at high risk of hospital admission and/or at the end of their life. They used a recognised method of assessing frailty to determine which patients were at risk.
• Home visits were available when needed.

Updated 18 April 2017

The provider is rated as good for this population group.

• The practice offered online services such as online booking and prescriptions
• The practice offered a range of health promotion and screening that reflected the needs for this age group.
• The practice offered coil fittings and referrals to sexual health clinics.
• The percentage of women aged 25-64 who have had a cervical screening test in the past 5 years was in line with the CCG and national average.
• There were early morning and later afternoon phlebotomy appointments available for this group.

Updated 18 April 2017

The provider is rated as good for this population group.

• 79% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the CCG and national average.
• Outcomes for patients with a mental health diagnosis were comparable or higher than the CCG and national average.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• Patients in this group had a named GP.
• There were leaflets and posters showing patients experiencing poor mental health about various support groups and voluntary organisations.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

Updated 18 April 2017

The provider is rated as good for this population group.

• The practice held a registers of patients living in vulnerable circumstances such as those with a learning disability and those who are homeless.
• Patients in this group were offered extended appointments.
• The practice worked with other health care professionals as needed in the case management of vulnerable patients.
• The practice referred and sign-posted vulnerable patients to various support groups and voluntary organisations.
• Staff had received training in identifying and reporting possible signs of abuse.
• The practice had identified 170 carers which was 1.2% of the patient list