Archived: Moredon Medical Centre

Updated 23 October 2019

The provider, Better Health Partnership LP, delivers regulated activities from its five main locations (and two branch locations). Only Moredon Medical Centre was inspected on this occasion. The addresses for these main sites are:

Moredon Medical Centre

Moredon Road,

Swindon.

SN2 2JG

Tel: 01793 342000

Website:

Website:

Abbey Meads Medical Group

Village Centre,

Elstree Way,

Swindon

SN25 4YZ

Tel: 01793 706030

Website: www.abbeymeadsdoctors.co.uk

Moredon Medical Centre is based in Swindon, Wiltshire, and is one of 24 practices serving the NHS Swindon Clinical Commissioning Group (CCG) area. A staffed reception area is located on the ground floor, and the practice has consulting/treatment rooms on the ground and first floors. The shared building houses the Swindon Urgent Care Centre and Expedited Surgery Scheme (SUCCESS). An independent pharmacy is also located on the premises. The practice is registered as a training practice.

In September 2018, Abbey Meads Medical Group, Moredon Medical Centre, Taw Hill Medical Practice, Eldene Surgery, and Phoenix Surgery began working collaboratively as a primary care network with the support of Integral Medical Holdings (IMH), who provide back-office services such as payroll, human resources, finance and management support. This collaboration was formed to maintain the services provided by these practices, and to look to develop new ways of working in line with the Government’s plan for primary care, the ‘General Practice Five Year Forward View’.

The new provider, now known as the Better Health Partnership LP, was registered with CQC in March 2019. GP partners of the old practice continue to be on the new Better Health Partnership LP registration, following IMH's withdrawal.

The practice has around 12,000 registered patients from an area surrounding the practice and Swindon town centre. The practice age distribution is broadly in line with the national average, with most patients being of working age or older.

The practice has a General Medical Services (GMS) contract to deliver health care services. (A GMS contract is a contract between NHS England and general practices for delivering general medical services and is the most common form of GP contract).

Moredon Medical Centre provides the following regulated activities:

• Treatment of disease, disorder or injury
• Diagnostic and screening procedures
• Maternity and midwifery services
• Surgical procedures
• Family planning

There are three GP partners (two male, one female), a long-term locum GP, one non-EU GP, and one GP registrar. The wider clinical team consists of a clinical nurse manager, two diabetic nurse specialists, two asthma and Chronic Obstructive Pulmonary Disease (COPD) nurse specialists, one practice nurse, two health care assistants (HCAs), two phlebotomists and a general manager. The practice team includes reception, administrative and secretarial staff. Moredon Medical Centre is a teaching practice.

Ninety-one per-cent of the practice population describes itself as white, and around 9% as having a Black, Asian and Minority Ethnic (BAME) background. A measure of deprivation in the local area recorded a score of 5, on a scale of 1-10. A higher score indicates a less deprived area. (Note that the circumstances and lifestyles of the people living in an area affect its deprivation score. Not everyone living in a deprived area is deprived and not all deprived people live in deprived areas).

Moredon Medical Centre is open from 7.15am to 6pm Monday to Friday, and the practice will take calls during these times. Routine and urgent GP appointments are also available during these times.

The practice has opted out of providing Out-Of-Hours services to its own patients. Outside of normal practice hours, patients can access the NHS 111 service, and an Out-Of-Hours GP is available at Swindon Walk-In Centre. Information about the Out-Of-Hours service was available on the practice website, in the patient registration pack, and as an answerphone message.

Updated 23 October 2019

We carried out an unannounced comprehensive inspection of Moredon Medical Centre on 13 and 14 August 2019, as part of our inspection programme. The inspection was a comprehensive follow up of the Special Measures imposed on the provider in March 2019 under the previous provider arrangements, and to follow up on the urgent conditions that were removed under the new provider arrangements. The inspection approach was unannounced, in response to urgent concerns raised by whistle blowers, and information provided to us from other sources. On 13 August 2019, the inspection focused on activities carried out at the hub, and how The Better Health Partnership LP operated as the registered provider. On the 14 August 2019, the inspection focused on how the regulated activities were provided from the location Moredon Medical Centre.

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.

In September 2018, Moredon Medical Centre began working collaboratively with five other practices in the Swindon area, with the support of Integral Medical Holdings (IMH), who provide back-office services such as payroll, human resources, finance and management support. This collaboration was formed to maintain the services provided by these practices, and to look to develop new ways of working in line with the Government’s plan for primary care, the ‘General Practice Five Year Forward View’. In March 2019 the practice was registered under a new provider, the Better Health Partnership. This was predominately a business and legal entity change, with the same people being responsible for the running of the practice as with the previous provider IMH. In May 2019, IMH withdrew from providing support services, but the structure has remained the same, with all correspondence and back office functions being managed at Moredon Medical Centre, which is known as the hub.

We have rated this practice as inadequate overall.

We rated the practice as inadequate for providing safe services because:

• The practice did not have clear systems and processes to keep patients safe.
• The practice did not have appropriate systems in place for the safe management of medicines.
• The practice did not learn and make improvements when things went wrong.

We rated the practice as requires improvement for providing effective services because:

• There was limited monitoring of the outcomes of care and treatment.
• The practice was unable to show that staff had the skills, knowledge and experience to carry out their roles.

We rated the practice as requires improvement for providing caring services because:

• Despite improvements, patient satisfaction scores were low relative to local and national averages.

We rated the practice as inadequate for providing responsive services because:

• Although improvements had been made, patients were unable to access services in a timely manner and there was a lack of continuity of care.

We rated the practice as inadequate for providing well-led services because:

• Leaders could not show that they had the capacity and skills to deliver high quality, sustainable care.
• While the practice had a clear vision, that vision was not supported by a credible strategy.
• The practice culture and structure did not effectively support high quality sustainable care.
• There was limited support from the provider Better Health Partnership to the local team at Moredon Medical Centre.
• The overall governance arrangements needed strengthening in order to be effective and sustainable.
• The practice did not have clear and effective processes for managing risks, issues and performance.
• The practice did not always act on appropriate and accurate information.
• We saw limited evidence of systems and processes for learning, continuous improvement and innovation.

Following the inspection, we issued Warning Notices to the provider registration of the Better Health Partnership, which relate to the location Moredon Medical Centre. This was in regard to the significant issues relating to patient safety, and leadership and governance.

This service was placed in special measures in April 2019. Insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall. We will proceed to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.

Special measures will give people who use the service the reassurance that the care they get should improve.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Updated 23 October 2019

Updated 23 October 2019

Updated 23 October 2019

Updated 23 October 2019

Updated 23 October 2019

Updated 23 October 2019