Archived: 3VHealthcare Limited - Thornbrook Surgery

Updated 15 July 2019

The provider has delivered services to patients since 2008. It is registered with the CQC to provide three regulated activities which are diagnostic and screening services; treatment of disease, disorder and injury; and surgical procedures.

3VHealthcare Limited delivers NHS consultant-led outpatient assessment and treatment clinics, and selected outpatient procedures, in a community setting. This encompasses specialties for dermatology, rheumatology, ophthalmology, gynaecology, ear nose and throat, and ultrasound and diagnostic services. Patients would normally have to travel to a hospital to access these services. The services are commissioned by NHS Derby and Derbyshire Clinical Commissioning Group (CCG) and delivered through an NHS contract.

3VHealthcare Limited – Thornbrook Surgery provides consultant-led NHS clinics in the Chapel-en-le-Frith area of the High Peak. The service works closely with the provider's other registered location, 3VHealthcare Limited – Goyt Valley Medical Practice situated half-a-mile away, which also provides consultant-led NHS clinics and an ultrasound scanning facility. As the two locations are separately registered with the CQC, there is a separate inspection report for 3VHealthcare Limited Goyt Valley Medical Practice which can be accessed on the CQC website www.cqc.org.uk

The office opening hours are Monday to Friday 8am to 5pm and patients can contact the service by telephone between 8.30am and 4.30pm. Appointments are available throughout the week at different times according to the specialty. Monthly ophthalmology clinics are held on a Saturday at the Goyt Valley site in Chapel-en-le-Frith, and the service has also recently introduced a Saturday clinic with an advanced ultrasound practitioner.

Patients are referred into the service by authorised clinicians, including GPs, nurse practitioners and optometrists. All clinical sessions are provided on the ground floor within a GP practice. Adequate parking is available for patients at each location.

Three GPs are the directors of 3VHealthcare Limited and there is also one non-executive director of the company. There is a management team comprising of an office manager, and three service managers with responsibilities for each specialty. Four administrative staff support the team and these staff are based in a health centre situated next door to Thornbrook Surgery. This is solely an administrative base and no regulated activities are provided from this site. 3VHealthcare Limited staff also use a room at Thornbrook Surgery which is rented from the practice. The service also utilises the services of a self-employed pharmacist and an administrator on a sessional basis.

There are 15 consultants, two GPs with extended roles (GPwERs), an associate specialist, a diagnostic radiographer and an advanced ultrasound practitioner who work for the service on a sessional basis but are not directly employed. Two specialist nurses (a rheumatology and an ophthalmology nurse) are employed on a zero hours contract to support the consultant clinics.

A GP from one of the practices which established the service is the registered manager, and this GP is also one of the three directors of 3VHealthcare Limited. 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.

How we inspected this service

Our inspection team was led by a CQC lead inspector, supported by a GP specialist adviser.

Prior to the inspection, we had asked for information from the provider regarding the service they provide.

During our visit we:

• Spoke with the three directors (including the registered manager), the office manager and a member of the administrative team.
• Reviewed the patient journey to consider how care was managed before and after consultations.
• Reviewed CQC comment cards and other feedback where patients and members of the public shared their views and experiences of the service.
• Reviewed documents and systems.

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 15 July 2019

This service is rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Outstanding

We carried out an announced comprehensive inspection at 3VHealthcare Limited – Thornbrook Surgery on 20 May 2019.

We carried out this announced inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions, to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

3VHealthcare Limited was last inspected in August 2018, but it was not rated as this was not a requirement for independent health providers at that time. Since April 2019, all independent health providers are now rated, and this inspection was undertaken to provide a rating for this service

Our key findings were:

• There was a clear vision to provide high quality, effective, and responsive care to the local population via a patient centred-approach. The service provided prompt and easy access to out-patient clinics for people residing locally. This was highly valued by patients who otherwise would need to travel to hospitals located some distance away, and the area was subject to poor transport links and frequent adverse weather in the winter months.
• Directors and managers spoke with passion about the service and their commitment to deliver a service to meet the needs of their patients. We saw evidence of strong, effective and dynamic leadership with close scrutiny of performance and outcomes to ensure a high-quality patient-centred service was maintained with an emphasis on continual improvement.
• The service provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs. Clinical staff used evidence-based guidance to ensure appropriate and effective treatment and advice was given to patients.
• The service dealt with patients with kindness and respect and involved them in decisions about their care. There was a strong focus on patient engagement with feedback mechanisms which were reviewed and acted upon.

• There was effective management of significant events and complaints.
• Staff told us there was an open and inclusive culture of management and felt their views were listened to.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care