Boultham Park Medical Practice Also known as Dr Whitlow & Partners

Updated 17 August 2016

Boultham Park Medical Practice is a GP practice which provides a range of primary medical services to around 9,500 patients from a surgery in Boultham, a suburb on the outskirts of the city of Lincoln in an area suffering a higher than average level of deprivation. The practice’s services are commissioned by Lincolnshire West Clinical Commissioning Group (LWCCG).

The service is provided by three full time male GP partners and two part time female partners who between them provide a total of 40 GP sessions per week. There is also a nursing team comprising a senior nurse, a practice nurse and two healthcare assistants. At the time of our inspection the practice were recruiting for a nurse practitioner and another practice nurse. They are supported by a practice manager and a team of reception and administration staff. Boultham Park Medical Practice is a training practice and at the time of our inspection there were two GP trainees in place.

The practice has a General Medical Services Contract (PMS). The GMS contract is the contract between general practices and their commissioner for delivering primary care services to local communities.

Local community health teams support the GPs in provision of maternity and health visitor services.

The practice has one location registered with the Care Quality Commission (CQC). The location we inspected was Boultham Park Medical Practice, Boultham Park Road, Lincoln. LN6 7SS.

The surgery is situated in modern purpose built premises with ample car parking which includes car parking spaces designated for use by people with a disability. The original building was extensively refurbished and extended in 1998-1999 with a further extension in 2012.

We reviewed information from Lincolnshire West CCG and Public Health England which showed that the practice population had deprivation levels which were higher than the average for practices in England. The practice has an above average elderly population and also an above average younger population of under eighteen year olds.

The practice is open between 8.00am and 6.30pm Monday to Friday with prebookable GP and nurse appointments available between 08.30am and 11.30am and 2.30pm and 5.30pm on a daily basis. Extended surgery hours are offered on Saturdays from 8.15am to 11.00am.

The practice has opted out of the requirement to provide GP consultations when the surgery is closed. The out-of-hours service is provided by Lincolnshire Community Health Services NHS Trust.

Updated 17 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Boultham Park Medical Practice on 25 May 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 areas where the provider should make improvement are:

To ensure secondary thermometers are used with the vaccine refrigerators in line with national guidance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 August 2016

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

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

• Performance for diabetes related indicators were better overall than the national average. For example the percentage of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months was 92%, compared to the CCG average of 90% and the national average of 88%.

• 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.

• There were effective recall procedures in place for monitoring of patients with non-attenders followed up by telephone.

• Integrated medication reviews were carried out for patients with multiple conditions.

Updated 17 August 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 practice’s uptake for the cervical screening programme was 77.5%, which was above the national average of 74%.

• Appointments were available outside of school hours with same day access to appointments for urgent children’s problems and Saturday morning surgeries for working families.

• We saw positive examples of joint working with midwives and health visitors with both being available on site as well as speech therapy clinics.

• Sexual health advice and signposting was available as well as contraception services including implant fitting/removal and emergency contraception.

Updated 17 August 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. Home visits were available by GPs, practice nurses and healthcare assistants for chronic disease management, phlebotomy and anticoagulant monitoring.

• The practice provided medical care and support to several large local residential and nursing homes.

• The practice actively engaged with the local Neighbourhood Team, Frailty Team and Primary Care Navigators to support older patients with integrated care.

• The practice held monthly multi-disciplinary team meetings to discuss palliative care patients, frail older patients and admissions of those on the ‘at risk of unplanned admission’ register.

Updated 17 August 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 reflected the needs for this age group.

• Sexual health advice and signposting was available as well as contraception services including implant fitting/removal and emergency contraception.

The practice offered extended opening hours on Saturdays to cater for working age people as well as good access to urgent same day appointments and telephone consultations.

Updated 17 August 2016

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

• 90% of patients diagnosed with dementia that had their care reviewed in a face to face meeting in the last 12 months, which is higher than the local average of 86% and the national average of 84%.

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

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

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

• The practice held registers of patients with mental health problems and dementia. Annual reviews were in place.

• Patients were able to access cognitive behavioural therapy and psychological therapies.

• The practice carried out dementia screening and referral for patients at risk.

• Staff undertook training in dementia awareness, Safeguarding & the Mental Capacity Act.

• GPs carried out assessments for Power of Attorney and mental capacity.

Updated 17 August 2016

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

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability.

• There was a learning disability lead at the practice and annual health checks were undertaken for patients with a learning disability with flexible appointments if necessary to minimise stress caused to patients attending the practice.

• The practice supported a neighbouring sheltered housing scheme for patients with a learning disability.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations such as the Citizen’s Advice Bureau, food banks, Age Concern, carers Groups and Primary Care Navigators.

• 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 worked with the local Drug and Alcohol Recovery Team (DART) and Addaction services to support patients with drug and alcohol problems.