Archived: Marybrook Medical Centre

Updated 3 March 2016

Marybrook Medical Centre is set in a village location near the Gloucestershire boundary approximately 12 miles south of Gloucester and 25 miles north of Bristol. The practice is situated a short walk away from the town centre in a purpose built building which was opened in 1977. The practice is surrounded by a good car parking area and all the facilities have good access.

The practice has a population of approximately 5050 patients. The practice has a higher than England average of patients aged 50 to 84 years of age and a lower than average group of patients up to the age of 40 years old. The practice has a deprivation score of 13.2 meaning the area has a lower deprivation compared to the Clinical Commissioning Group average of 14.7 and a lower deprivation than the national average of 23.6.

The practice had a General Medical Services contract (GMS) with NHS England to deliver general medical services. The practice provided enhanced services which included extended hours for appointments; facilitating timely diagnosis and support for patients with dementia; learning disabilities and minor surgery.

The practice team includes four GP partners (3 male and 1 female), who provide 2.75 whole time equivalent sessions. The practice does not use locum GPs and instead the GP partners provide additional working hours to cover each other when required. In addition the practice employs two practice nurses; a health care assistant; a practice manager and administration staff which includes receptionists and secretaries.

The practice is open between 8.30am and 6.30pm Monday to Friday except Wednesdays when the practice closes at 1.00pm. During this time the GP partners provide an on-call service for patients who need urgent care. Appointments are from 8.30am to 11.50am daily and 2pm to 6pm; except Wednesdays when appointments end at 1pm. Extended hours surgeries are offered every Monday from until 7.45pm. The national GP patient survey (July 2015) reported patients were satisfied with the opening times and making appointments. The results were in line with local and national averages.

The practice has opted out of providing Out Of Hours services to their own patients. Patients can access NHS 111 and South Western Ambulance Service provided an Out Of Hours GP service.

Updated 3 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Marybrook Medical Centre on 26 November 2015. 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 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. Staff provided us with examples of kindness and compassion.
• Information about services and how to complain was available and easy to understand.
• 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. (Duty of Candour is a legal duty to ensure providers are open and transparent with people who use services. It also sets out specific requirements providers must follow when things go wrong with care and treatment, including informing people about the incident, providing reasonable support, providing truthful information and an apology when things go wrong).

We saw one area of outstanding practice:

• The practice provided a staff and volunteer led support service for vulnerable and isolated patients and their carers. For example, patients who were recently bereaved or had a new dementia diagnosis.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 March 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.

• 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 3 March 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 patients who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.

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

• 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.

• The practice provided a sexual health and contraception clinic for younger people living in the area.

Updated 3 March 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 patients in its population.

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

• The practice provided a specific GP to deliver a weekly ward round to the local care home ensuring continuity of care.

Updated 3 March 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 reflects the needs for this age group.

• A mobile phone text service was used to provide reminders for patients to contact the service.

Updated 3 March 2016

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

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  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 ran a fortnightly support group which offered patients diagnosed with dementia and other health needs and their carers activities, friendship and social support.

Updated 3 March 2016

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

• The practice held a register of 17 patients living with a learning disability and offered longer appointments for patients with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients.

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

• The practice provided a practice run fortnightly support group for carers and other patients.

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.