Chew Medical Practice

Updated 20 February 2018

Chew Medical Practice is situated in a purpose-built building which opened in 2012. The practice address is: Chew Medical Practice, Chew Lane, Chew Stoke, Bristol, BS40 8UE. The practice serves a population of approximately 9400 patients; there are low levels of social deprivation in the area, but some pockets of rural deprivation and many isolated members of the community. The practice population has a higher proportion of older people compared to local and national averages; 25% are over the age of 65 compared to a local figure of 19% and a national figure of 17%.The practice is open between 8am and 6pm Monday to Friday except on Wednesdays when the practice is open until 7.30pm. Appointments are available from 8am to 1pm every morning and from 2pm to 5.45pm daily. Extended surgery hours are offered until 7.30pm on Wednesdays and every Saturday from 9am to 11.30am. In addition to pre-bookable appointments that could be booked up to six weeks in advance, urgent appointments are also available for people that needed them.

When the practice is closed from 6pm overnight until 8am and at weekends, the out of hours (OOH) cover is provided by Bath Doctors Urgent Care. Patients are advised via the practice website that this is accessed via NHS 111.

The practice was able to offer dispensing services to those patients on the practice list who lived more than one mile (1.6km) from their nearest pharmacy. The dispensary is open Monday to Friday between 8am to 6pm, with late opening on Wednesdays until 7.30pm. It also opens from 9am until 12noon on Saturday mornings. Patients are able to choose whether to have medicines dispensed at the surgery or in the local village pharmacy, if this was more convenient for them.

The practice is a teaching and training practice, and supports medical students, student nurses and trainee GPs.

The practice employs three GP partners, two male and one female, five salaried GPs, a team of four nurses, two health care assistants and a phlebotomist. The practice is supported by a management team including a practice manager, two assistant practice managers and a full team of support staff, including administrators, receptionists and dispensers.

Updated 20 February 2018

This practice is rated as Good overall. (Previous inspection February 2016 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Chew Medical Practice on 16 January 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• The practice had supported the introduction of a weekly choir group for new mothers experiencing postnatal depression.The choir had developed into a support network for all new mothers as a vehicle to prevent problems developing.
• The practice worked closely with village agents who acted as a support network for those patients who were experiencing hardship, health issues or were isolated in their community.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a focus on continuous learning and improvement at all levels of the organisation, through regular clinical audits, participation in national research projects as well as being a teaching practice for all levels of medical and nursing students, and GP trainees.

We saw one area of outstanding practice:

• The practice had introduced an Early Home Visiting Scheme (EHVS). The purpose of this was to ensure that frail elderly patients could be assessed and a management plan commenced to help prevent hospital admission. We saw evidence that demonstrated that admissions had reduced from 180 per 1000 patients in the four months before the scheme to 153 per 1000 patients in the four months after the scheme started. The practice had the lowest admissions rate to Accident & Emergency and acute admissions in the Bath & North East Somerset (BANES) area, despite having a higher than average population of elderly patients.

The areas where the provider should make improvements are:

• Fully embed arrangements for management oversight of systems and processes in relation to medical alerts and infection control.
• The practice should invite patients who are also carers for an annual health check.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 20 February 2018

Updated 20 February 2018

Updated 20 February 2018

Updated 20 February 2018

Updated 20 February 2018

Updated 20 February 2018