Archived: Chesterton Medical Centre

Updated 21 January 2016

Chesterton Medical Centre is the registered location and head office for the out-of-hours GP service provided by Cambridge Doctors On Call Limited (also known as Urgent Care Cambridgeshire). The service contracts with NHS Cambridgeshire and Peterborough Clinical Commissioning Group (CCG) to provide primary medical services outside of usual working hours (out-of-hours or OOH) when GP practices are closed. The service covers a population of approximately 650,000 across the county of Cambridgeshire. Cambridgeshire is a relative affluent county with pockets of deprivation.

Patients access the out-of-hours service via NHS 111. Calls from NHS 111 are received and triaged at Chesterton Medical Centre and patients who need to be seen are allocated an appointment at one of the four primary care centres or as a home visit. Patients may also receive a telephone consultation with a clinician.

The primary care centres are located at:

Chesterton Medical Centre, Union Lane, Cambridge, CB4 1PX

Hinchingbrooke Hospital, Hinchingbrooke Park, Huntingdon, PE29 6NT

Doddington Hospital, Benwick Road, Doddington, PE15 0UG

Princess of Wales Hospital, Lynn Road, Ely, CB6 1DN

The primary care centres located at Chesterton Medical Centre, Hinchingbrooke Hospital and Doddington are open Monday to Friday 6.30pm to 8am and 24 hours on a Saturday, Sunday and bank holidays. The primary care centre at the Princess of Wales Hospital is open Monday to Friday between 6.30pm and midnight and 7am to midnight on a Saturday, Sunday and bank holidays.

During our inspection we visited two primary care centres at Chesterton Medical Centre and Hinchingbrooke Hospital.

The service is predominantly GP led. There are approximately 123 GPs contracted on a sessional basis to provide the out of hours service across the four primary care centres. The service also employs a variety of other clinicians (approximately 50) including nurse practitioners, emergency care practitioners and more recently pharmacists. The service is supported by a team of non clinical staff who support the running of the service.

The service was previously inspected as a pilot site for the new CQC inspection methodology in March 2014. The service was found to be compliant with the regulations relating to the Health and Social Care Act 2008.

The service does not currently have a registered manager with CQC and have been made aware of this. A registered manager application has since been submitted which is currently in progress.

Updated 21 January 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Chesterton Medical Centre on 3 and 4 November 2015. Overall the service is rated as good.

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

• Staff understood their needs to raise concerns. There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events and for sharing learning.
• Risks to patients were generally very well managed. However, the service did not have robust systems to assure itself that health and safety issues were being addressed where services were provided to patients.
• Patient care was assessed and delivered in a timely way according to need. The service performed well against the National Quality Requirements for GP out-of-hours care.
• Patients said they were treated with compassion, dignity and respect and were satisfied with the care and treatment they received from the service.
• Information about services and how to complain was available and easy to understand. The service responded with care and compassion when responding to sensitive complaints.
• Adherence to appointment times given for face to face consultations was frequently raised in patient feedback.
• The primary care centres where patients were seen had good facilities and were well equipped to treat patients and meet their needs. Vehicles used for home visits were clean and also well equipped.
• There was strong and clear leadership. Staff felt supported by senior management and directors who were visible on shifts to support the smooth running of the service.
• The provider was aware of and complied with the requirements of the Duty of Candour.
• The service worked proactively with other organisations and with the local community to develop services that supported hospital admission avoidance and improved the patient experience.
• The service had a clear vision which focussed on quality and safety. The service was responsive to feedback received and used information available proactively to drive service improvements.

We saw areas of outstanding practice:

• Despite meeting national quality requirements the service actively investigated the small proportion of patients where breaches had occurred. As a result of these exercises the service had employed a prescribing pharmacist at peak times to deal with prescribing and medicine queries in a more timely way and to free other clinicians to see patients. Early signs had shown this was having a positive impact. For example, in one day they had been able to deal with 37 out of 38 medicine queries received with only six requiring a face to face consultation with a clinician.

The areas where the provider should make improvement are:

• To assure itself that appropriate arrangements are in place across all primary care sites in relation to health and safety and the management of the premises.

• Continue to ensure patient expectations around appointment times are managed.

• Maintain a robust audit trail for the management of ‘stat dose’ medicines administered to patients on site.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice