Archived: Camphill Health Centre

Updated 13 June 2017

Camphill Health Centre is located within the Camphill area of Nuneaton. This is a highly deprived area with levels of deprivation well above the average for the Clinical Commissioning Group and national statistics.

The practice building is a modern, purpose built facility owned by NHS Facilities and shared with the district nursing team, the local MacMillan nursing team and the community dental service. At the time of our inspection, 4236 patients were registered at the practice which is operated by IMH (Incorporating Malling Health) under an Alternative Provider Medical Services (APMS) contract with NHS England. The APMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.

There is a large number of families with children registered at the practice and 907 patients (21% of the patient list) are aged 9 years and under. The number of children on the child protection register is well above the national average. In contrast, only 85 patients (2% of the patient list) are aged over 85.

The practice has a lead GP and a salaried GP (both male). There are also three nurse practitioners and a health care assistant. Nurses and the health care assistant provide chaperone duties when a female patient requests that a female accompanies them at a GP appointment. Clinical staff are supported by two practice managers and administrative and reception staff. Practice management are supported by the IMH regional management team who have overall oversight of practice performance, finance and human resources.

The practice is open from 8am to 6.30pm during the week. Appointments are available throughout those times. Extended hours appointments are available on Tuesdays from 6.30pm to 8.30pm. When the practice is closed patients can access out of hours care provided by Care UK Clinical Services located in George Eliot Hospital, Nuneaton through NHS 111. A GP walk-in centre is also available there.

Home visits are available for patients who are unable to attend the practice for appointments. There is also an online service which allows patients to order repeat prescriptions and book new appointments without having to telephone the practice. Telephone appointments are available for patients who are unable to reach the practice during normal working hours.

The practice treats patients of all ages and provides a range of medical services. This includes minor surgery and disease management such as asthma, diabetes and heart disease.

Updated 13 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Camphill Health Centre on 25 April 2017. Overall the practice is rated as good.

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

• Risks to patients were assessed and well managed.
• There were clearly defined processes and procedures to ensure patients were safe, with an effective system for reporting and recording significant events.
• Patients said they were treated with dignity, respect and compassion. Patients were involved with decisions about their care and treatment.
• Urgent same day patient appointments were available when needed. Patients we spoke with said they were always able to obtain urgent same day appointments when needed.
• Patients’ needs were assessed and care delivered in line with current guidelines. Staff had the appropriate skills, knowledge and experience to deliver effective care and treatment.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Information about how to complain was available and easy to understand.
• Patients said GPs gave them enough time.

However there were areas of practice where the provider should make improvements:

• Continue to identify ‘hidden’ carers among the patient list.

• Continue to closely monitor and encourage patients to attend screening for breast, bowel and cervical cancer.

• Continue to take action to identify and act on areas to improve patient satisfaction.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 13 June 2017

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

• The practice had a register of patients with long term conditions to enable their health to be effectively monitored and managed.

• Longer appointments and home visits were available when needed.

• Patients had a named GP and a review every 12 months to monitor their condition and ensure they received correct medicines. This also included carers if the patient had one. The frequency of the review depended on the severity of the patient’s condition. Due to the high prevalence of diabetes in the local area, patients with this condition were reviewed every nine months.

• All patients who had been prescribed eight or more medicines (polypharmacy) had a medicine review within the last 12 months.

• The practice achieved a 99% influenza vaccination record for diabetic patients during 2015/16. This was above the CCG average of 97% and the national average of 94%.

Updated 13 June 2017

The practice is rated as good for the care of families, children and young people.

• A total of 75% of eligible patients had received cervical screening in the last 12 months. This was below the CCG average of 83% and similar to the national average of 81%.

• There were appointments outside of school hours and the practice building was suitable for children and babies.

• Outcomes for areas such as child vaccinations were in line with the average for the CCG.

• We saw positive examples of joint working with midwives and the local health visitor.

• Due to the higher than average number of children on the child-protection register within the local area, regular safeguarding meetings were held with the local health visitor team.

• A monthly multi-disciplinary team meeting was held with the midwife and health visitor. The child protection register and non-attendance for immunisations and checks were reviewed at this meeting.

• A full range of family planning and sexual health services were available within the practice building.

Updated 13 June 2017

The practice is rated as good for the care of older people.

• Care plans were in place with the most vulnerable older patients (2%) and used with multi-disciplinary teams to reduce unplanned hospital admissions. These patients had an alert placed on their patient records to ensure clinical staff were aware.

• Older patients were given personalised care which reflected their needs.

• Over the last 12 months all patients aged 75 and over had been invited for a health check. This included blood tests, fracture assessment, frailty assessment, and checks for depression and dementia.

• Home visits were offered to patients who could not reach the practice.

• Nationally reported data showed that outcomes for older patients were in line with local and national averages.

• The Patient Participation Group (PPG) had prioritised this population group and in conjunction with practice management had ensured that any patient aged over 65 who had not seen a GP within the last 12 months had been identified and contacted. Any such patients identified as being particularly isolated were given details of events held at the local community centre to help their emotional well-being.

• Contact details for carers and support workers were recorded in patient notes. Patients were regularly asked to review these details. Any new carers identified were then placed onto the carer’s register.

Updated 13 June 2017

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

• The practice ensured it provided services to meet the needs of the working age population. For example, extended hours appointments were available until 8.30pm on Tuesdays.

• Telephone consultations were available for patients who were unable to reach the practice during the day.

• Appointments could be booked on-line and text message reminders were also sent.

• Regular reviews of the appointment system were held to ensure patients could access the service when they needed to. This had recently resulted in additional telephone appointments being made available.

• A full range of services appropriate to this age group was offered, including travel vaccinations and smoking cessation.

• An ‘in-house’ phlebotomy (blood taking) service was available.

Updated 13 June 2017

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

• The practice had a register of patients with poor mental health to enable their health to be effectively monitored and managed.

• The practice worked with multi-disciplinary teams to provide appropriate care for patients with poor mental health. This included patients with dementia.

• Patients were signposted to appropriate local and national support groups. This included the local Mental Health Service.

• Staff demonstrated a good working knowledge of how to support patients with mental health needs and dementia.

• Contact details for carers and support workers were recorded in patient notes. Patients were regularly asked to review these details. Any new carers identified were then placed onto the carer’s register.

Updated 13 June 2017

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

• The practice had a register of patients who were vulnerable to enable their health to be effectively monitored and managed. This included patients with a learning disability.
• The practice supported vulnerable patients to access various support groups and voluntary organisations.
• Longer appointments were available for patients with a learning disability.
• The practice worked with other health care professionals to provide care to vulnerable patients, for example, the district nursing team and community matron. Vulnerable and complex patients were discussed at the monthly multi-disciplinary team meeting.
• Staff could recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities to share appropriate information, record safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.
• The practice building was fully accessible and met the requirements of the Disability Discrimination Act.