The University Medical Centre

Updated 6 February 2017

University Medical Centre is located in the city of Canterbury. The practice operates from one location:

University Medical Centre, Giles Lane, Canterbury, Kent, CT2 7PB.

The practice has approximately 16,500 registered patients and provides services under an NHS General Medical Services contract. It is part of NHS Canterbury and Coastal Clinical Commissioning Group (CCG). The practice is situated in a purpose built building on the edge of the grounds of University of Kent’s Canterbury campus. It is based in an area of relatively low deprivation compared to the national average for England. Seventy three percent of the practice list size are aged 18 to 24 years and there are only 97 patients aged over 75 years registered with the practice. The practice told us there were 128 nationalities represented on campus. A total of 57% of patients at the practice have a long-standing health condition which is similar to the CCG average of 55% and the national average of 54%.

The practice has three GP partners, two male and one female. The practice also employs three female salaried GPs. Together the GPs provide care equivalent to approximately 50 sessions per week or just under five whole time equivalent GPs. The GPs are supported by one advanced nurse practitioner, seven practice nurses, and a health care assistant. All the nursing team are female and together provide care equivalent to just under four whole time nurses. The clinical team are supported by a management team including two practice managers and 12 secretarial and administrative staff. The practice is a teaching practice for foundation year two doctors and student nurses. At the time of our inspection the practice was supporting one doctor as part of their foundation training.

University Medical Centre is open between 8am and 6.30pm Monday to Friday. Extended hours surgeries are available every Tuesday and Thursday evenings until 9pm during term time and Easter vacation only. Patients are encouraged to use the NHS 111 service before 8am and after 6.30pm and have access to the university nursing service which is available 24 hours a day, seven days a week.

Updated 6 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at University Medical Centre on 24 October 2016. 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 significant events.
• Risks to patients were assessed and well managed.
• The practice was the lead primary care service provider of mental health services for four local clinical commissioning groups. As a consequence the practice offered a range of mental health services to its patients and patients not registered at the practice, including psychological therapies and an eating disorder service.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with 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.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and 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.
• 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.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Consider a process to review and analyse significant events to identify any trends and maximise learning.
• The practice should improve systems for the recording and management of prescription pads.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 6 February 2017

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

• The practice had a mixed skill set within the clinical team to provide services in chronic disease management.
• Longer appointments and home visits were available when needed.
• 88% of patients with diabetes had received a flu vaccination in the last 12 months. This was lower than the clinical commissioning group (CCG) and national average of 94%.
• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. 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.

Updated 6 February 2017

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. Immunisation rates were relatively high for all standard childhood immunisations.
• Patients told us that young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• 83% of eligible women received a cervical smear in the preceding five years, which is similar to the national average of 82%.
• The practice offered a three-tier sexual health service at the practice. This included a chlamydia screening service, an express clinic where patients can attend a 15 minute appointment with a health care assistant or practice nurse and a mercury clinic which offered advice and testing by a specialist sexual health nurse.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, and health visitors.

Updated 6 February 2017

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.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice had a dedicated phone line so patients and their carers could speak directly to the specialist care planning nurse or the designated administrative lead.so that their needs could be addressed in a timely way.

Updated 6 February 2017

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.
• The practice provided 24 hour care seven days a week through the University Nursing Service located on campus.
• The practice offered immunisation clinics for students such as meningitis and MMR.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group. 

Updated 6 February 2017

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

• 100% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is higher than the national average of 84%. The practice worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• 62% of patients with schizophrenia, bipolar affective disorder and other psychoses had an agreed care plan recorded, which is lower than the national average of 89%.
• The practice employed two psychiatric liaison nurses who provided specialist services five days a week for patients with complex and urgent mental health needs. In addition the practice employed a team of 45 mental health workers who provided a primary care psychological therapies service (IAPT) five days a week across four  clinical commissioning groups. We saw questionnaires in the waiting room asking students about their mental health and providing advice about where to access appropriate services.
• The practice provided a mild to moderate primary care eating disorder service five days a week to patients registered with Canterbury and Coastal CCG Practice.  
• The practice had told patients experiencing poor mental health about how to access 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.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 6 February 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice informed 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.