Background to this inspection
Updated
19 July 2019
Clay Cross Medical Centre is registered with the CQC as a partnership of two GPs.
The practice is situated in the Clay Cross area of North-East Derbyshire. It has a contract with NHS Derby and Derbyshire Clinical Commissioning Group (CCG) to provide General Medical Services (GMS) and offers a range of local enhanced services.
The practice operates over two sites:
- Clay Cross Medical Centre, Bridge Street, Clay Cross, Chesterfield, Derbyshire. S45 9NG (main site)
- Tupton Surgery, Queen Victoria Road, Tupton, Chesterfield, Derbyshire. S42 6ED (branch site).
The practice has one patient list, meaning that registered patients can access services at either of the two sites. We visited the main site as part of this inspection.
The practice has a population of 6,125 registered patients. There has been a slight reduction in patient numbers since our previous inspection. Patients are predominantly of white British origin with 2.1% of patients being from BME groups. The age profile of registered patients shows a higher percentage of older patients in comparison to national averages, with 25% of their patients aged 65 and over, in comparison to a national average of 17%. The practice serves a population that is ranked in the fifth more deprived decile for deprivation.
The clinical team consists of two GP partners (one male and one female). A part-time male GP was working at the practice as part of the GP retention scheme. Regular locum GPs also provided input at the practice at the time of our inspection, whilst the partners were seeking recruitment to a salaried GP vacancy.
There are two advanced nurse practitioners and three practice nurses, a part-time pharmacist, and a healthcare assistant. The clinical team is supported by a practice manager and assistant practice manager (who is also the practice’s care coordinator), two senior administrators, and a team of 12 reception, secretarial and administrative staff.
The main site opens from 8am until 6.30pm Monday to Friday, with extended opening hours until 8pm on one day each week. Scheduled GP appointment times are available each morning between 8.30am to 12pm and each afternoon from 3pm to 6pm. Appointments are available during the extended opening hours until 7.45pm. The branch site opens at different times.
Patients can also access a local extended hours scheme to see a GP, nurse, or other health professional which operates from 6 to 8pm weekdays, 7.30am to 10.30am on Saturdays, and 8 to 11am on Sundays. This service also provides some additional appointments during practice opening times.
The surgery closes for one Wednesday afternoon each month for staff training. When the practice is closed, patients are directed to Derbyshire Health United (DHU) out of hours via the 111 service.
Updated
19 July 2019
We carried out an announced comprehensive inspection at Clay Cross Medical Centre on 3 July 2018. The overall rating for the practice was ‘good’, however, the practice was rated as ‘requires improvement’ for providing effective services. This was because:
- The practice’s achievement for the Quality and Outcomes Framework (QOF) had reduced by approximately 20% from the previous year’s performance.
- Annual health reviews had only been completed for approximately half of the patients included on the practice’s learning disability register.
- Records of meetings did not always provide clear evidence of discussions having taken place on new guidance, complaints and significant events.
- The prescribing of broad-spectrum antibiotics was higher than local and national average percentages.
The practice was asked to develop an action plan to address the areas of concern that were identified during our inspection.
The full comprehensive report and evidence table can be found by selecting the ‘all reports’ link for Clay Cross Medical Centre on our website at
This inspection was an announced focused inspection carried out on 3 July 2019 to review the actions taken by the practice since our previous inspection in July 2018. This report covers our findings in relation to actions taken by the practice since our last inspection.
Overall the practice remains rated as ‘good’. The practice is now also rated ‘good’ for providing effective services. All population groups are now rated as good with the exception of ‘people with long-term conditions’ which remains as ‘requires improvement’ as further work is required to improve outcomes for patients with diabetes.
Our key findings were as follows:
- The practice had improved its overall QOF performance from 78.8% in 2017-18, to 94% in 2018-19. These figures remain subject to external verification.
- Whilst there had been good improvement for QOF achievement across the clinical domains, there was further work needed to maximise outcomes within indicators relating to diabetes. The practice was aware of this and had a clear plan in place to try and address this.
- The practice was monitoring antibiotic prescribing by regular audits and were taking action to ensure prescribing was undertaken in line with guidance.
- The practice had identified more carers since our previous inspection and had systems in place to advise and support them appropriately.
- Minutes from meetings were comprehensive and provided clear evidence that topics (for example, new guidance) were discussed and acted upon.
- Evidence of the immunisation status of staff was available.
- The uptake of annual health reviews for patients with a learning disability had increased.
There was one area in which the provider should continue to make improvements:
- Continue with plans to improve outcomes for patients with diabetes.
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