Denham Medical Centre

Updated 15 July 2022

Denham Medical Centre is a two-site GP practice located in Denham, Buckinghamshire and Iver Heath, Buckinghamshire. The practice provides general medical services to approximately 10,500 patients.

The practice is part of the Buckinghamshire Clinical Commissioning Group (CCG). (A CCG is responsible for planning and designing local health services in a specific geographic area. They do this by 'commissioning' or buying health and care services).

The practice is also part of a wider network of GP practices, this is known locally as the South Bucks Primary Care Network (PCN).

Services are provided from two locations:

• Denham Medical Centre, Queen Mothers Drive, Denham Garden Village, Buckinghamshire UB9 5GA
• Aysgarth Medical Centre, Church Road, Iver Heath, Buckinghamshire SL0 0RW

The practice website is:

• www.denhammedicalcentre.co.uk

The provider is registered with CQC to deliver the following Regulated Activities:

• Diagnostic and screening procedures
• Family planning services
• Maternity and midwifery services
• Surgical procedures
• Treatment of disease, disorder or injury

According to information published by the UK Health Security Agency (UKHSA) there is minimal deprivation in Buckinghamshire, specifically Denham, Iver and the surrounding areas have high levels of affluence and low levels of deprivation. The practice population has a higher proportion of patients aged 50 and over when compared to the national average and there is a proportion of patients in a local care home (approximately 82 registered patients).

According to the latest available data, the ethnic make-up of the practice area is 83% White, 12% Asian, 2% Mixed, 1.5% Black and 1.5% Other.

There are six GPs (two GP Partners, one salaried GP and three long-term locum GPs) at the practice. The nursing team consists of two nurse prescribers, five practice nurses and one health care assistant with a mix of skills and experience. The team also includes a Physician Associate, a First Contact musculoskeletal (MSK) Practitioner, pharmacist, social prescriber and care coordinators. The practice manager, assistant practice manager, reception manager and a team of reception and administrative staff undertake the day to day management and running of the practice.

The practice has opening hours between 8.30am and 1.30pm and 4.30pm and 6.30pm. Between 8am and 8.30am and 1.30pm and 4.30pm a GP remains on site and calls are diverted to a call deputising service. Furthermore, Denham Medical Centre closes at 1.30pm every Thursday and Aysgarth Medical Centre closes at 1.30pm every Wednesday and Friday. Extended hours appointments were available at one of the locations between 6.30pm and 8pm every Tuesday evening. The practice offers a range of appointment types including improved access, extended hours, book on the day, telephone consultations and advance appointments.

When the practice is closed out of hours services are provided by FedBucks GP out of hours service which patients can access via the NHS111 service.

Updated 15 July 2022

We carried out an announced desk-based review inspection at Denham Medical Centre in Buckinghamshire on 1 July 2022. Overall, the practice is rated as Good.

At our previous inspection in March 2020, the service was rated Good overall, however we identified concerns relating to an aspect of the provision of effective services to ‘working-age people’. The specific concerns were due to cancer screening performance and cancer-related outcomes. We therefore rated the ‘working-age people’ population group as Requires Improvement.

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

Why we carried out this inspection

In October 2021, we (Care Quality Commission) amended how we report and rate GP practices. Although the amendment saw the removal of population groups, this inspection reviewed information and followed up on the improvements the practice had made in relation to cancer screening performance and cancer related outcomes, both of which had contributed to the ‘working-age people’ population group being rated Requires Improvement. We have not changed or provided any updated ratings at this inspection.

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Review of cancer outcome data
• Requesting evidence from the provider

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.

At this inspection, on 1 July 2022, we found the practice had addressed the issue identified at the last inspection.

We found that:

Following the March 2020 inspection, the practice reviewed cancer screening performance and cancer-related outcomes with a view to improve uptake. The review led to a variety of actions, this included:

• The appointment of one of the GPs to become the practice ‘Cancer Champion’ – a designated lead role, to oversee how the practice managed cancer outcomes. They attended external training and meetings and shared findings with the full practice team.
• Practice staff joined an interactive primary care network (PCN) event facilitated by a leading cancer charity.
• Further PCN work reviewed and benchmarked cancer performance across the four other GP practices within the PCN.
• An additional focus on early diagnosis initiatives, cancer-related clinical audits and different tools of patient engagement.
• Engagement with the Thames Valley Cancer Alliance, specifically the early diagnosis and innovation pathway.
• The practice provided evidence which demonstrated the actions had been successful and improvements had been made. This included improvements in cancer screening performance, cancer-related outcomes and cancer indicators.

We also saw the practice had made additional improvements in the area we asked them to consider at the last inspection, for example:

• The practice had continued to make improvements in the delivery of the child immunisation programme, this included improvements across all age groups. For example, 98% of children aged one had completed a primary course of immunisation for Diphtheria, Tetanus, Polio, Pertussis, Haemophilus influenza type b (Hib), Hepatitis B (Hep B) ((i.e. three doses of DTaP/IPV/Hib/HepB). This was a 3% increase on the previous data collection.

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

• Continue to improve the uptake of cervical screening.

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

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care