Archived: OxFed Health & Care Ltd

Updated 10 May 2017

Hollow Way Medical Centre is the administration headquarters of OxFed Health and Care Ltd (OxFed). Patient services are not delivered from the Medical Centre but the management team are based here. OxFed formed in late 2014 when 21 GP practices in the City of Oxford were successful in obtaining funding for the service. OxFed is managed by a board comprising three GPs and a practice manager, supported by three senior officers. There are two services currently managed by OxFed.

• A team of seven care navigators (care navigators are health or social care professionals who support patients to access the health and care services they need to continue to live independently). This service was found to be outside of the scope of regulation and is not included within this report.
• Since September 2016 clinical co-ordination of the work of Oxford University college nurses has been provided. Two of the college nurses, including the senior nurse, are employed by OxFed. A further 16 nurses employed directly by their colleges receive the clinical supervision service. The 18 nurses work across 30 university colleges from medical facilities that are the responsibility of the colleges to maintain. The nursing staff offer students a walk in service at all 30 college sites. The student patients are not registered with OxFed and can register with any GP practice within Oxford.

The staff that provide the college nursing services are supported by 10 administration staff. The provider does not hold responsibility for scheduling or managing the college clinics. These are organised by the college welfare departments and are all established as drop in clinics without appointments. OxFed provides a clinical advice and support service to the nurses between 8am and 6pm Monday to Friday.

The services delivered by OxFed are reliant upon short term contracts paid for from project funds and contributions from member practices. Consequently staff are issued with short term contracts that are scheduled to expire when project funding comes to an end. The OxFed governing board maintain an operational plan that timetables when the next round of bidding for funding is due. Evaluation of the services provided is agreed with commissioners of the service and has been limited by both the contract agreements and support staffing until recently.

In addition OxFed led the implementation of the patient record viewer in the Out of Hours service. This enables Out of Hours clinicians working at bases in Oxford and Abingdon to view the patient record of patients registered with OxFed practices during the Out of Hours consultation. OxFed developed this service in consultation with GP practices and the Out of Hours service

We visited the Hollow Way Medical Centre at : Hollow Way Medical Centre, 18 Ivy Close, Cowley, Oxford, Oxfordshire, OX4 2NB.

We also visited six college medical rooms that are owned and managed by the respective university colleges.

Updated 10 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hollow Way Medical Centre (OxFed) on 8 March 2017. Due to the nature of the service inspected we did not apply ratings. OxFed Health and Care Limited (OxFed) is a health federation that works with the 21 GP practices in Oxford City. The Hollow Way Medical Centre site is used by the federation as their administrative headquarters. Clinical services are not provided by the federation at this location. At the time of inspection OxFed was providing two services. These were:

• A team of seven care navigators that work with patients in their own home. Following inspection we found this service did not undertake any regulated activities and is out of scope of CQC registration. Therefore it is not included within this report.
• A college nursing service delivered by two nurses employed by OxFed offering nursing support to students at colleges of the Oxford University. Clinical oversight and supervision is also given to 16 more nurses employed by various university college sites.

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 provider had clearly defined and embedded systems to minimise risks to patient safety.

• 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.
• Information about services and how to complain was available.
• The college nursing service operated from appropriate facilities and staff were equipped to treat patients and meet their needs.
• Information was shared with the patient’s GP and other agencies when relevant to the care of the patient and where consent was taken.
• There was a clear leadership structure and staff felt supported by management. The provider proactively sought feedback from staff and patients, which it acted on.

The areas where the provider should make improvement are:

• Prioritise the development of quality improvement monitoring of the services provided.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 May 2017

The provider was able to demonstrate.

• College nursing staff were appropriately trained to support patients diagnosed with long term diseases. For example, in management of asthma.
• Staff were aware of support groups in the area that supported patients with long term conditions.
• If a student patient with a long term condition required additional medical support with their condition they were referred back to their registered GP in a timely manner.

Updated 10 May 2017

The provider was able to demonstrate:

• The needs of the student population had been identified and the provider had responded by offering services that met their needs. For example, drop in clinics that were appropriately promoted.
• The provider made health promotion material and advice leaflets available in electronic formats which students could access at any time. Similar electronic access to health promotion material was available via the university websites and in hard copy format from college medical rooms.

• Staff were aware that many student patients were living away from their families for the first time. They made time to listen to these patients by offering open ended consultations giving students time to talk through their concerns.

Updated 10 May 2017

The provider was able to demonstrate:

• They held information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations. Staff were able to refer to student counselling services.

• Staff were aware of local support groups outside of the colleges to which students could be directed when appropriate

Updated 10 May 2017

The provider was able to demonstrate:

• The college nurses worked with other health care professionals in the case management of vulnerable patients.
• Staff had information available for vulnerable patients about how to access various support groups and voluntary organisations.
• Nurses worked with GP practices when new students entered college at the start of autumn term. Additional clinics were held to ensure students were up to date with immunisations and identify any students with long term medical conditions.
• Staff we spoke with knew how to recognise signs of abuse in 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.