Archived: Barnwood Medical Practice

Updated 18 July 2016

Barnwood Medical Practice is located within a modern purpose built centre called the Aspen Centre which is shared with other healthcare providers, in a suburb of the city of Gloucester. The practice is wheelchair accessible with automatic doors and lifts to the practice.

The practice is approved for training qualified doctors who wish to become GPs and provides general medical services to approximately 5,800 patients. Services to patients are provided under a General Medical Services (GMS) contract with NHS England. (A GMS contract is a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract).

The Practice has four GP partners (two male and two female) and one GP Associate (male) which is equivalent to four whole time GPs. The clinical team consist of three practice nurses, two healthcare assistants and one trainee healthcare assistant (all female). The practice management team comprises of a practice manager and a business manager who are supported by ten administrators/receptionists.

Information from Public Health England 2015 shows the practice population age distribution is comparable to both local and national averages. Of the working population 4% were unemployed which is below the national average of 5%.

The general Index of Multiple Deprivation (IMD) population profile for the geographic area of the practice is in the second least deprivation decile. (An area itself is not deprived: it is the circumstances and lifestyles of the people living there that affect its deprivation score. Not everyone living in a deprived area is deprived and that not all deprived people live in deprived areas). The prevalence of patients with a long standing health condition is 57% compared to the local clinical commissioning group (CCG) average of 55% and the national average of 54%. People living in more deprived areas and with long-standing health conditions tend to have greater need for health services.

Average male and female life expectancy for the practice is 79 and 84 years respectively, which is comparable to the national averages of 79 and 83 years.

The practice is open between 8.30am and 6.30pm on Monday to Friday. Between 8am - 8.30am every weekday telephone calls are picked up by the reception team and a duty doctor is on site to treat any medical emergencies. Appointments are available between 8.30am and 5.40pm. Extended surgery hours are offered every Monday evening between 6.30pm and 8pm.

Out of Hours cover is provided by South Western Ambulance Service NHS Foundation Trust and can be accessed via NHS 111.

The practice provides its services from the following address:

Barnwood Medical Practice

Aspen Centre

Horton Road

Gloucester

Gloucestershire

GL1 3PX

This is the first inspection of Barnwood Medical Practice.

Updated 18 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Barnwood Medical Practice on 7 June 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Ensure all staff have received their appraisals within the 12 month cycle.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 July 2016

The practice is rated as good for the care of patients 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.

• Performance for overall diabetes related indicators in 2014/15 was 99% which was above both the clinical commissioning group average of 95% and the national average of 89%.

• 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 18 July 2016

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

• 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 patients 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 patients were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• The practice’s uptake for women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding five years in 2014/15 was 84% which was comparable to the clinical commissioning group average of 84% and the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies. There were baby changing and feeding rooms available.

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

Updated 18 July 2016

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

• The practice offered proactive, personalised care to meet the needs of the older patients in its population and had a range of enhanced services, for example in influenza, pneumococcal and shingles immunisations.

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

• The practice visited local care homes on a weekly basis.

• The practice held weekly meetings with community based staff to discuss the care of patients in this population group including those receiving palliative care.

Updated 18 July 2016

The practice is rated as good for the care of working-age patients (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.

• Extended hours appointments were available from 6.30pm to 8pm on Monday evenings for patients to attend outside of routine working hours.

• The practice offered telephone consultations for all patients which was useful for working patients.

Updated 18 July 2016

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

• 92% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months (04/2014 to 03/2015), which is above both the clinical commissioning group average (CCG) of 86% and the national average of 84%.

• Performance for mental health related indicators was 100% compared to the CCG average of 97% and national average of 82%.

• 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 and all staff had received Mental Capacity Act training.

Updated 18 July 2016

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

• The practice held a register of patients living in vulnerable circumstances including homeless 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.

• The practice participated in a local social prescribing initiative.