Atrium Health Centre

Updated 12 April 2017

Atrium Health Centre is situated in the town of Dorchester, Dorset. The practice has a Personal Medical Services (PMS) contract with NHS England and is part of NHS Dorset clinical commissioning group (CCG).

The practice population is approximately 7,780 patients. The deprivation decile rating for this area is eight (with one being the most deprived and ten being the least deprived). This meant that this area is relatively affluent compared to the national average. The 2011 census data showed that 98% of the local population identified themselves as being white British. The practice is a teaching practice and had medical students at the practice.

The practice has a team of four GPs partners and a salaried GP, three of whom are female and two are male. Some work part time and some full time. The whole time equivalent for the GPs employed is four. Partners hold managerial and financial responsibility for running the business. The team are supported by a practice business manager, a practice manager, a nurse prescriber, four practice nurses, three health care assistants, dispensary and additional administration staff.

Patients using the practice also have access to the CADAS (community alcohol drug advisory service) community nurses, and mental health teams who are based in the same building as the practice. Other health care professionals visit the practice on a regular basis. The practice had a branch site which also contained a dispensary service for patients. The practice offered dispensing services to those patients on the practice list who lived more than one mile from their nearest pharmacy.

The practice is open between 8am and 6.30pm Monday to Friday. Appointments are offered anytime within these hours. Extended hours surgeries for routine appointments are offered every other Saturday morning between 8.30am and 12 noon. Outside of these times patients are directed to contact the out of hour’s service by using the NHS 111 number. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

The practice provides regulated activities from a main location and a branch location. The main location is situated at The Atrium, 7 Weymouth Avenue, Dorchester, Dorset DT1 1QR.

The branch location is located at Crossways Surgery, Old Farm Way, Crossways, Dorset DT2 8TU. We only visited the branch location during this inspection. 

Updated 12 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Atrium Health Centre on 30 August 2016. The overall rating for the practice was good. The full comprehensive report on the August 2016 inspection can be found by selecting the ‘all reports’ link for Atrium Health centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 15 February 2017 to assess the dispensary service. This report covers our findings in relation to our inspection on the 15 February 2017.

Overall the practice remains rated as good.

Our key findings were as follows:

• In relation to the dispensary risks to patients were assessed and well managed.
• Blank prescription forms and pads were securely stored at the branch practice and there were systems in place to monitor their use.
• Systems were in place to deal with any medicines alerts or recalls, and records were kept of any actions taken in the dispensary.

However, there were areas of practice where the provider should make improvement:

• Ensure the dispensary systems are in place, such as risk assessment of security of medicines and a full audit trail and DBS check processes completed for the delivery service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 6 October 2016

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• The percentage of patients with diabetes, on the register, in whom the last IFCC-HbA1c is 64 mmol/mol or less in the preceding 12 months was 77% which was the same as the national average.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 6 October 2016

The practice is rated as good for the care of families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• The percentage of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding five years was 79% which was comparable with the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 6 October 2016

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Updated 6 October 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

• Relevant health promotion material was available through the practice.

Updated 6 October 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

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  89% of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan which was comparable to the national average of 88%.

• The practice liaised closely with the in house mental health team who were based in the same building as the practice to support this population group.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 6 October 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• 1.5% of the practice list were registered as being currently homeless. The practice supported these patients, for example by registering their home address as being at the practice. One GP specialised in care for the homeless. This GP provided same day appointments for homeless patients as these patients did not usually book an appointment in advance. They organised secondary care, acute medicine and appropriate treatment for homeless patients who often had complex conditions.

• The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff 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.