Archived: North Norfolk Primary Care

Updated 25 September 2019

The registered provider is North Norfolk Primary Care.

• The address of the service is Aylsham Community Health Centre, St. Michaels Avenue, Aylsham, Norwich, NR11 6YA.
• The improved access service is operated from four satellite sites which are NHS GP practices separately registered with the CQC. The sites are:
  • Birchwood Medical Practice, Park Lane, North Walsham, Norfolk, NR28 0BQ
  • Cromer Group Practice, Mill Road, Cromer, Norfolk, NR27 0BG
  • Fakenham Medical Practice, Meditrina House, Trinity Road, Fakenham, Norfolk, NR21 8SY
  • Hoveton and Wroxham Medical Practice, Stalham Road, Hoveton, Norfolk, NR12 8DU
• North Norfolk Primary Care is a private limited company providing NHS funded care services, including improved access GP appointments and an enhanced care home visiting team, on behalf of the 19 member GP practices in North Norfolk. The provider has a board of directors and each member practice has nominated a GP to hold its shares on the practice’s behalf, governed by its Articles of Association and a Shareholders’ Agreement.
• The website is www.northnorfolkprimarycare.co.uk
• The operating times for the service are:
  • Improved Access: 5pm to 8pm Monday to Friday. 9am to 12pm Saturday and Sunday
  • Enhanced Care Home Team: 9am to 5pm Monday to Friday.

How we inspected this service

Before visiting, we reviewed a range of information we hold about the service and asked them to send us some pre-inspection information which we reviewed.

During our visit we:

• Spoke with a range of staff from the service including members of the executive board, nurses, doctors and management staff.
• Reviewed a sample of treatment records.
• Reviewed comment cards where clients had shared their views and experiences of the service.
• Looked at information the service used to deliver care and treatment plans.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 25 September 2019

We carried out an announced comprehensive inspection at North Norfolk Primary Care on 2 September 2019 as part of our inspection programme. This is the first inspection of North Norfolk Primary Care.

North Norfolk Primary Care is a private limited company providing NHS funded care services, including improved access GP appointments and an enhanced care home visiting team, on behalf of the 19 member GP practices in North Norfolk. The provider has a board of directors and each member practice has nominated a GP to hold its shares on the practice’s behalf, governed by its Articles of Association and a Shareholders’ Agreement.

The chief executive officer is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We received 18 comment cards, all of which were wholly positive about the service. Comments included that staff took time to listen to patients and the appointment system was easy to use. The provider had collated feedback given by care homes and practices they supported. They had received nine pieces of feedback which were wholly positive about the service. We spoke with two external stakeholders who used the service and the feedback was positive about the way the provider worked with them. They told us they liaised regularly with their service to ensure patients got the care they needed.

Our key findings were :

• Improved access GP appointments were offered from four GP practices ensuring the service was accessible to all patients across North Norfolk.
• Patients were supported, treated with dignity and respect and were involved in decisions about their care and treatment.
• Patients’ needs were met by the way in which services were organised and delivered.
• Feedback from patients on the day of inspection, including CQC comment cards, was positive about the care received by the provider.
• The service completed audits on the effectiveness of the service.
• Feedback from external stakeholders was positive about the service provided.
• There was a positive culture and staff were enthusiastic and positive about the care they provided.

However, we also found that:

• The leadership, governance and monitoring of risks arrangements of the service did not always ensure the delivery of high-quality care.
• The service could not evidence that all the checks required to employ staff appropriately were in place.
• The service had not implemented effective systems to ensure appropriate and safe provision of emergency medicines and equipment.
• The service did not have assurance that the premises from where they delivered services from were safe for their intended purpose. For example, they did not have oversight of up to date fire safety, health and safety or infection prevention and control risk assessments.
• As a result of feedback given on the day of the inspection, the provider shared with us an action plan to drive the improvements needed.

The areas where the provider must make improvements as they are in breach of regulations are:

Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care