Archived: Epping Close Surgery

Updated 27 September 2017

Epping Close Surgery provides primary care services for services for approximately 3,450 patients in Clacton and the surrounding areas of Great Clacton. The practice has an Alternative Provider Medical Services (APMS) contract to provide Primary Care Services. The APMS contract is commissioned by NHS England and performance managed by NHS North East Essex CCG.

Epping Close Surgery is part of a larger organisation known as Anglian Community Enterprise (ACE). ACE have four GP practices in this part of Essex, one in Clacton, another in Holland-on-sea, one in Frinton, and another in Jaywick. ACE, provide community care, health and well-being, primary care, and learning disability services in Essex. ACE is a not for profit, staff owned, social enterprise that delivers services under NHS contracting regulations. Their resources include access to clinical staff leadership, information governance, risk, and health and safety management at an organisational level provided across their four practice locations.

Epping Close Surgery population has high levels of deprivation amongst children and a larger than average population of older people. This area is amongst the 20% most deprived neighbourhoods in the country. The life expectancy of patients within the practice area is lower than local and national averages.

The clinical team comprises two salaried GPs, one full-time female and one part-time male and regular locum GPs for sessions three times a week. There is also a clinical pharmacist, nurse practitioner/prescriber, a practice matron, a practice nurse, a healthcare assistant, and a phlebotomist all female. The administrative team of six staff hold a variety of full-time and part-time hours with roles including receptionists, audit clerk, prescribing clerk, medical secretary, assistant practice manager and a practice manager.

The surgery opening hours are Monday, Tuesday and Thursday 7.30am until 6.30pm and Wednesday and Friday 8.00am until 6.30pm.

The surgery appointment times are:

Monday 7.30am to 9.30am or 10am to 12.30pm and 3pm to 5.30pm or 4pm to 6pm.

Tuesday 8.30pm to 12.30pm or 9am to 12.30pm and 3pm to 5.30pm or 4pm to 6pm.

Wednesday 8.30pm to 12.30pm or 9am to 12.30pm and 3pm to 5.30pm or 4pm to 6pm.

Thursday 8.30pm to 12.30pm or 9am to 12.30pm and 3pm to 5.30pm or 4pm to 6pm.

Friday 8.30pm to 12.30pm or 9am to 12.30pm and 3pm to 5.30pm or 4pm to 6pm.

The practice has opted out of providing GP out of hour’s services. Patients calling the practice outside practice working hours are advised by the answerphone message to contact the 111 non-emergency services. Patients requiring urgent treatment are advised to contact the out of hour’s service provided by Care UK.

Updated 27 September 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Epping Close Surgery on 19 July 2017. Overall, the practice is rated as good.

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

• Staff members knew how to raise concerns, and report safety incidents.
• Safety information was appropriately recorded; and learning was identified and shared with all staff.
• The infection control policy met national guidance.
• Risks to patients and staff were assessed, documented and acted on appropriately.
• The practice had arrangements and processes to keep adults and children safe and safeguarded from abuse.
• Staff assessed patient care in line with current evidence based guidance.
• Staff showed they had the skills, knowledge, and experience to deliver effective care and treatment.
• Clinical audits were undertaken and we saw two completed cycles enabling improvements to be measured.
• Patients said they were treated with compassion, dignity, respect, and involved in their care and treatment decisions.
• Information about the practice services and how to complain was available in the waiting room, and on the practice website in easy to understand formats.
• The practice was aware of and complied with the requirements of the duty of candour when dealing with complaints and significant events in an open and honest manner.
• Patient satisfaction results published in the July 2017 national GP patient survey reflected that patients were not satisfied with the practice across a number of areas measured.
• The practice facilities, and equipment was appropriate to treat and meet patient’s needs.
• There was a clear leadership structure and in addition, staff members felt supported by the GPs and practice management team.

The areas where the provider must make improvements are:

• Ensure improvement is made to patient satisfaction in the areas identified in the July 2017 national GP patient survey.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 27 September 2017

The practice is rated as good for providing services to people with long-term conditions.

Services provided by the practice for this population group were:

• Diabetes checks.
• Chronic obstructive pulmonary disease (COPD) monitoring.
• Asthma checks.
• Nursing team staff and GPs held lead roles in chronic disease management.
• Double appointments and home visits when needed.
• Those people with long-term conditions (LTC) had a named GP and a structured annual review to check their needs were met.
• Practice prescribers used clinical templates designed to ensure patients received blood tests and diagnostic checks required, before repeat prescriptions were given to patients.
• The clinical pharmacist provided dedicated medication reviews focussing on complex medications or polypharmacy to ensure prescribing was safe and to educate patients on the best use of their medication.
• The practice matron used a risk based stratification tool to maintain admission avoidance and prevent hospital admissions.
• Liaison with the community specialist LTC teams and active use of ‘Consultant Connect’ service were in use to provide optimum care.
• Patients at risk of hospital admission were identified as a priority. Personalised care plans ensured continuity of care.

Updated 27 September 2017

The practice is rated as good for providing services to families, children and young people.

Services provided by the practice for this population group were:

• Family planning.
• Immunisations.
• Baby checks.
• Travel clinics.
• Cervical screening.
• Appointments available outside school and college hours.
• Premises suitable for children and babies.
• Online services to book appointments and request repeat prescriptions.
• Ante/post-natal provision at the practice by Colchester Hospitals midwives.
• SMS telephone texting reminders.
• Electronic prescribing service (EPS) from patients preferred pharmacy.
• A system to follow-up children living in disadvantaged circumstances or at risk, for example, those who had a high number of A&E attendances.
• Support from the ACE organisation safeguarding lead, and a link safeguarding nurse and GP at the practice.

Updated 27 September 2017

The practice is rated as good for providing services to older people

The practice offered personalised care to meet the needs of older people within its population, services included:

• A weekly Audiology service, provided assessment of hearing needs, and repairs/replacement batteries for aids.
• Health & Wellbeing checks.
• In-house minor surgery.
• Flu & travel vaccination.
• Specific appointments for people using ‘dial-a-ride’, to book a convenient appointment with secured transport.
• The practice offered home visits and urgent appointments to those that needed them.
• The practice matron provided a visiting service for the housebound to manage long-term conditions. Acute episodes or hospital admissions of this population group generated contact within 48 hours to review their care plan, and on-going needs by the practice matron.
• All older people had a named GP.
• A hearing loop is available and well signposted at reception.
• Palliative care meetings took place every six to eight weeks where patients identified as frail and at risk of deteriorating health were discussed and care plans updated.
• There was a good uptake for shingles and flu vaccinations due to pro-active practice campaigning.
• Senior health checks were available and offered, during consultations to maximise their uptake.

Updated 27 September 2017

The practice is rated as good for providing services to working age people.

Services provided by the practice for this population group were:

• Appointments from 7.30am on Mondays and until 6pm each weekday evening.
• On-line and mobile technology solutions with appointments.
• Electronic prescribing service (EPS) from patients preferred pharmacy.
• SMS telephone texting reminders.
• A full range of health promotion and screening that reflects the needs of this age group.
• Access to health advisors working with patient’s between18-75 years of age at a one to one appointment followed by group sessions.
• Availability of health and wellbeing checks.
• Medical checks for insurance and work.

Updated 27 September 2017

The practice is rated as good for providing services to people experiencing poor mental health (including people with dementia).

Services provided by the practice for this population group were:

• ‘On the day’ appointments were provided for people experiencing acute mental health issues.
• Double appointments were offered to support patients with complex needs, or a telephone review to provide reassurance and follow-up in a familiar home setting.
• Accreditation as a ‘Dementia Friendly Practice’ was being worked towards with all staff undertaking dementia awareness training.
• The practice hosted bi-monthly dementia clinics for patients, family members and carers provided by an Alzheimer’s society support worker.
• Work with multi-disciplinary teams supported patients experiencing poor mental health, and included those with dementia.
• Staff were trained to safeguard adults and children from abuse.
• Staff were familiar with the details of the Mental Capacity Act.
• The staff had received guidance to direct patients that needed mental health support appropriately.
• Information in the waiting room and on the practice website told patients experiencing poor mental health how to access support groups and voluntary organisations.
• Patients that had attended accident and emergency who experienced poor mental health were followed up.

Updated 27 September 2017

The practice is rated as good for providing services to people whose circumstances may make them vulnerable.

Services provided by the practice for this population group were:

• Recognition of patients living in vulnerable circumstances including, the homeless, travellers, and those with a learning disability.
• Access to double appointments for patients with a learning disability.
• Case management of vulnerable patients with other health care professionals for treatment planning.
• Information for vulnerable patients about access to support and voluntary organisations.
• Staff were trained to recognise signs of abuse and manage safeguarding concerns.
• Safeguarding procedures at the practice and the policy met current legislation. Guidance and support was also provided by the Anglian Community Enterprise (ACE) organisation leads.
• The GP safeguarding lead at the practice attended forums when possible.
• GP care advisor sessions were provided to guide and support patient with the completion of benefit claims forms, and assessments for mobility aids.
• Strong effective relationships built over time by long serving staff ensured vulnerable people were identified. Vulnerable people, where suitable, had alerts attached to their records to allow staff members to act appropriately when dealing with them.