Millstream Medical Centre

Updated 27 January 2023

Millstream Medical Centre is located in Salisbury, Wiltshire at:

Millstream House

Avon Approach

Salisbury

SP1 3SL

The practice has a branch surgery at:

Larkhill Medical Centre

Willoughby Road

Larkhill

Salisbury

SP4 8QY

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services and treatment of disease, disorder or injury and surgical procedures. These are delivered from both sites.

The practice offers services from both a main practice and a branch surgery. Patients can access services at either surgery. There is a dispensary service located at the branch surgery. We visited both sites as part of this inspection.

The practice is situated within the Wiltshire Integrated Care System (ICS) and delivers General Medical Services (GMS) to a patient population of about 10,800. This is part of a contract held with NHS England.

The practice is part of a wider network of GP practices, Salisbury Plain Primary Care Network (PCN), comprised of Sarum Health Group (Millstream Medical Centre and Larkhill Medical Centre) and Avon Valley Practice. Patients registered at these practices are able to benefit from the iniatives set-up by the PCN, such as mental health care provision and intermediate health care support at local residential care homes.

Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the third highest decile (eight of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 96% White, 2.3% Asian, 1.1% Mixed, 0.5% Black and 0.1% Other.

There is a team of four GPs who provide cover at both practices. The practice has a team of seven nurses who also provide nurse led clinics for long-term condition of use of both the main and the branch locations. The GPs are supported by two pharmacists and a home visiting team comprised of a paramedic and an advanced nurse practitioner. The practice has a team of 16 reception and administration staff based across both sites. The practice manager is based at the main location to provide managerial oversight, whilst the assistant practice manager is based at the branch location.

The practice is open between 8am to 6:30pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

Extended access is provided by Salisbury Walk-in Centre, located within Millstream Medical Centre, where late evening and weekend appointments are available. Out of hours services are provided by NHS 111.

Updated 27 January 2023

We carried out an announced comprehensive inspection at Millstream Medical Centre on 07 December 2022. Overall, the practice is rated as Good.

Safe - Good

Effective - Good

Caring - Good

Responsive - Good

Well-led - Good

Following our previous inspection on 20 February 2019, the practice was rated Good overall and for all key questions.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Millstream Medical Centre on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection as this was the first inspection under the new provider registration. This inspection covered all five domains – safe, effective, caring, responsive and well-led.

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Conducting staff interviews using video conferencing.
• Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A short site visit.
• Obtaining information and feedback by external stakeholders

Our findings

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.

We found that:

• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• Patients could access care and treatment in a timely way.
• The practice engaged with patients and the local community to obtain feedback to support service delivery and meet patient needs.
• Data was above national averages for patient satisfaction from the most recent GP national patient survey.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

Whilst we found no breaches of regulations, the provider should:

• Continue to work with other services in the shared building to improve risk mitigation for fire safety, namely dedicated warden training and increased evacuation drills.
• Improve the uptake of cervical cancer screening and childhood immunisation to eligible patients.
• Implement the planned system to catch up with the backlog of records summarising.
• Take action to uphold oversight of required Controlled Substances Hazardous to Health (COSSH) data sheets in relation to all cleaning products stored at the practice.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services