Archived: Guildhall Walk Healthcare Centre

Updated 25 October 2017

Guildhall Walk Health Centre located at 27 Guildhall Walk, Portsmouth, Hampshire. PO1 2RY is a converted commercial premises. The practice is located in the centre of Portmouth. The practice covers a diverse community incorporating a large proportion of university students. Within the area there are pockets of deprivation. The practice also has older patients with complex needs, patients who are homeless, patients with a mental health condition and 22.3% of all children aged 0-19 years old, are deemed as living in poverty in Portsmouth under the Children in Low Income Households Measure.

The provider of the practice, Partnering Health Limited became the personal medical services contract holder in 2016. The service was originally a Walk-in service decommissioned in July 2016. The practice now is a conventional GP practice with around 7300 patients.

Care and treatment is provided by three salaried GP’s and two long-standing locums. Two GPs are male and three GPs are female. There are two practice nurses and one healthcare assistant. The practice also has an Advanced Nurse Practitioner. There is an established practice manager and a team of receptionists, secretaries and administrators.

The practice telephone lines and reception desk are open from 8am to 6.30pm on Monday to Friday. Appointments are available between 8am and 6.30pm daily. Extended hours appointments are offered on Mondays and Fridays between 8am and 8pm. The practice is open every Saturday for appointments from 8am until 12 midday. During extended hours appointments reception is also open.

Each day the practice has walk-in appointment slots for registered patients which are available during these time periods until all of the slots have been allocated. The practice provides 15-minute appointments for all patients who use the walk-in clinic. It is also possible to pre-book routine appointments in advance daily.

Out of Hours urgent medical care was provided via the NHS 111 service when the practice was closed.

Updated 25 October 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Guildhall Walk Health Centre on 31 August 2017. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise many risks to patient safety however there were areas that could be improved upon.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients told us that they found it easy to make an appointment with a GP and there was continuity of care, with urgent appointments available the same day.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• The practice proactively looked out for children with additional needs and introduced a ‘Medical Passport’. The aim of this was to ensure that the clinical and non-clinical staff were aware of how best to support the child whilst they were at the surgery. The passport was scanned onto the child’s electronic file with an alert for staff to read it prior to any clinical interaction.

• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Consider reviewing the patient information leaflet to include full details of the practice complaints procedure.
• Consider reviewing the recruitment policy to make sure it details the recruitment procedure.
• Consider reviewing the whistleblowing policy to include details of external agencies who could provide support to staff.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 25 October 2017

The practice is rated as good 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.

• The practice followed up on patients with long-term conditions after a hospital admission and ensured that their care plans were updated to reflect any additional needs.

• There were emergency processes for patients with long-term conditions who experienced asudden deterioration in health.

Updated 25 October 2017

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

• There were systems to identify and follow up children living in disadvantaged circumstances and those who were at risk, for example, children and young people who had a high number of accident and emergency (A&E) attendances.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• The practice worked with midwives and health visitors to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.

• The practice proactively looked out for children with additional needs and introduced a ‘Medical Passport’. The aim of this was to ensure that the clinical and non-clinical staff were aware of how best to support the child whilst they were at the surgery. The passport was scanned onto the child’s electronic file with an alert for staff to read it prior to any clinical interaction.

Updated 25 October 2017

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

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.

• The practice offered proactive, personalised care to meet the needs of the older patients in its population.

• The practice was responsive to the needs of older patients, and offered urgent appointments for those with enhanced needs.

• The practice identified at an early stage of care and treatment of older patients who may need palliative care. Older patients were involved in planning and making decisions about their care, including their end of life care.

• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.

• Where older patients had complex needs, the practice shared summary care records with local care services. For example, the practice followed up any unplanned hospital admissions calling the patient within 24 hours of discharge.

• The practice offered flexible appointments for carers.

Updated 25 October 2017

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

• The needs of this population group were identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care. For example, extended opening hours and Saturday appointments.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflect the needs for this age group.

• The practice was located near to the University of Portsmouth campus and offered services to students. For example during the first week of term the practice provided student health care advice.

• The practice provided sexual health pop-up clinics in partnership with Solent NHS Trust.

Updated 25 October 2017

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

• The practice carried out advance care planning for patients living with dementia.

• The practice was an accredited dementia friendly practice.

• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.

• From unverified data supplied by the practice for 2016-2017, they had achieved 23 points out of a possible 26 points (89%) for Quality and Outcomes Framework for patients experiencing poor mental health.

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

• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.

Updated 25 October 2017

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

• The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability.

• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.

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