Brayford Medical Practice

Updated 4 July 2016

Brayford Medical Practice is a surgery close to Lincoln City Centre in a residential area which has student accommodation. The practice is located in a multi storey building and this practice is based on the ground floor. Brayford Medical Practice is one of the practices within NHS Lincolnshire West Clinical Commissioning Group and provides general medical services to approximately 6130 registered patients.

The practice is equipped for patients that are disabled or have limited mobility and has good public transport links.

• All services are provided from: 34 Newland, Lincoln, Lincolnshire, LN1 1XP.

• The practice comprises of three GP Partners (one female and two male).

• The all female nursing team consists of a practice nurses and a health care assistant.

• A practice manager and a team of ten reception and administrative staff undertake the day to day management and running of the practice.

• The practice population has a higher proportion of patients aged between 20 and 34 compared to the national and CCG average and lower than average proportion of patients aged over 60.

• The practice has core opening hours between 8am and 6.30pm every weekday.

• The practice provides extended hours surgeries on Wednesday when the practice opens from 7am to 9pm.

• There are appointments that can be booked on the day or in advance with GPs or the nurse.

• The practice opted out of providing the out-of-hours service. This service is provided by the out-of-hours service accessed via the NHS 111 service. Advice on how to access the out-of-hours service is clearly displayed on the practice website, on the practice door and over the telephone when the surgery is closed.

Updated 4 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Brayford Medical Practice on 26 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, incidents and near misses.
• Risks to patients were assessed and well managed.
• Procedures were in place for monitoring and managing risks to patient and staff safety.
• 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 feedback.

• Patients said they found it easy to make an appointment however there were comments that at times it was difficult to get through on the telephone.

• 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 practice understood the needs of the local population and planned services to meet those needs.
• The practice scored higher than CCG and national averages in all aspects of care according to the GP patient survey.
• Historically outcomes for patients who use services were consistently good. Nationally reported Quality and Outcomes Framework (QOF) data, for 2012/13 and 2013/14, showed the practice had performed well in obtaining almost all of the total points available to them for providing recommended care and treatment to patients. We saw evidence of data irregularities for the 2014/15 period and saw the practice was seeking a resolution to these irregularities.
• The PPG were not active.

The areas where the provider should make improvement are:

• Complete appraisals annually with all staff to provide support and identify training requirements.
• Ensure that the patient participation is active and in place

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 4 July 2016

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

• Performance for diabetes related indicators showed the practice had achieved 63% of targets which was lower than both the CCG average (91%) and the national average (89%).

• This was discussed with the practice and it was identified that the practice did not have a lead for this disease since the previous nurse had left. The practice agreed that this was an area that they would look to improve on as 2013/14 figures showed the practice at 92% for diabetes indicators.

• Longer appointments and home visits were available when needed.

• All patients had a named GP and a structured annual review to check their health and medicines needs were being met.

Updated 4 July 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.

• 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 79%, which was comparable to the CCG 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.

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

Updated 4 July 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.

• The practice were linked to a care home in the area were they had patients residing at and worked closely with the care home staff to provide reviews and home visits were necessary.

Updated 4 July 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.

• The practice were open from 7am to 9pm Wednesdays for flexibility with appointments.

• Appointment triage and telephone consultations were available.

Updated 4 July 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 had a system in place to follow up patients who had attended accident and emergency including those that may have been experiencing poor mental health.

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

Updated 4 July 2016

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

• The practice had a high level of patients that were homeless or in temporary accommodation under the care of the probation service. These patients were able to attend without making an appointment however the practice encouraged this to be during surgery times.

• 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.