Anchor Centre GP Practice

Updated 27 April 2017

The Anchor Centre GP Practice provides high quality primary health care services to approximately 500 homeless and vulnerably housed people in Coventry. The practice is part of the Virgin Care group. The patient population consists mainly of persons aged between 20 years of age to 54 years of age with a small number of a younger and older age, a large percentage of these are male.

The practice staff comprises of one salaried GP, an Advanced Nurse Practitioner (ANP), practice nurse, practice manager and reception staff.

Services to patients are provided under an Alternative Provider Medical Services (APMS) contract. An APMS contract provides the opportunity for locally negotiated contracts. They allow contracts with non-NHS bodies, such as voluntary or commercial sector providers, to supply enhanced and additional primary medical services. The Anchor Centre provides the following regulated activities: Treatment of disease, disorder or injury; Family planning; Surgical procedures.

The practice is open 9am to 4pm Monday to Friday.  The practice provide an additional specialist clinic once a week. The service for patients requiring medical attention out of hours is provided by the local walk in centre or NHS 111 service.

Updated 27 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Anchor Centre GP Practice on 11 January 2017. Overall the practice is rated as Outstanding.

Our key findings across all the areas we inspected were as follows

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.

• The practice used innovative and proactive methods to improve patient outcomes, working with other agencies. For example, supporting patients to gain employment and housing.

• The practice tailored services to meet the needs of individual people and were delivered in a way to ensure flexibility, choice and continuity of care.

• We saw that staff were able to identify and respond to changing risks to patients including deteriorating health and well-being.

• Feedback from patients about their care was consistently positive.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice actively reviewed complaints and how they are managed and responded to, and made improvements as a result.
• The practice had a clear vision to improve the health of vulnerable and excluded groups which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.

We saw several areas of outstanding practice including:

• The practice took a holistic approach to patient care, recognising the need to meet their emotional well-being as well as their health needs. For example, supporting them to write CVs, prepare for job interviews, join cookery clubs and allotment societies

• The practice provided extensive in-house services for the patient groups. It had been identified that attendance when patients were signposted to the external agencies was low, so the practice decided to arrange in-house weekly sessions. As the agencies became part of the practice team and patients became familiar with the staff the attendance and use of the support increased. Some of the agencies now providing weekly sessions at the practice, were The Law Society, a housing organisation and a dental nurse.

• There was numerous evidence to demonstrate that a number of patients had been supported by the practice to gain full time employment and housing.

There are areas where the provider should make improvements:

• The provider should continue to encourage patients to engage with the cervical screening programme.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 27 April 2017

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

• Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.

• Due to the specialist nature of the service, a meaningful comparison of the practice’s performance against that of other practices in relation to the Quality and Outcomes Framework (QOF) could not be drawn. However the practice undertook opportunistic reviews when the patients attended the practice.

• Many patients with long term conditions did not stay registered for long enough to complete all the health checks and tests required for their condition. We saw that the practice implemented opportunistic reviews for patients

• The practice worked with relevant health and care professional to deliver multidisciplinary care.

Updated 27 April 2017

We have not included the families, children and young people population group as the practice did not have any patients registered in this range.

Updated 27 April 2017

We have not included the older people population group as the practice had only a small number of patients registered in this range.

Updated 27 April 2017

The practice is rated as outstanding for the care of working age people (including those recently retired and students).

• The needs of these populations had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care, for example, a drop in clinic once a week.

• A systematic approach was taken to working with other organisations to improve care outcomes, and tackle health inequalities. The practice team worked collaboratively with a wide range of voluntary organisations for example, liaising with these organisations to enable patients to take part in activities such as tending allotments, cookery courses and education courses.

• The practice offered 20 minute appointments as routine. This recognised the needs of the patient group who frequently wished to discuss a range of health and social needs.

• The practice encouraged and provided support for patients to attend a variety of training courses including numeracy and literacy, preparation for maintaining future tenancies, and other vocational subjects.

Updated 27 April 2017

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

• A community Psychiatric Nurse provided a weekly service and offered specialist support in addressing difficulties such as addiction and substance abuse. This partnership enabled the practice to manage the patients’ health as the majority required Mental Health Support and in-house provision had resulted in improved patient engagement.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.

• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia.

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

• Patients were supported to take up opportunities to access services they might not have otherwise considered.

Updated 27 April 2017

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

• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.

• We saw numerous examples where the practice had supported and enabled patients to find housing and full time employment and where the practice had made a difference to patients’ lives.

• The practice nurses made significant effort to encourage patients to engage in treatments and tests known to be of benefit for patients who were homeless or vulnerably housed.

• Referrals were made to hospitals in a timely manner and patients were offered the support to attend hospital appointments.

• The practice funded a professional counsellor who attended the practice weekly. They provided psychological therapy for customers with chaotic lifestyles and support for them to adapt to life off the streets where possible.

• The practice provide ‘dignity cards’ for patients that could not read or write. These were completed with basic demographic information, so that patients were not embarrassed when asked to complete forms.

• Patients were supported to take up opportunities to access services they might not have otherwise considered.