Benhill and Belmont Practice

Updated 21 March 2017

Benhill and Belmont GP Centre provides primary medical services in Sutton to approximately 11500 patients and is one of 28 practices in the NHS Sutton Clinical Commissioning Group (CCG). The practice operates under a Personal Medical Services (PMS) contract and provides a number of local and national enhanced services (enhanced services require an increased level of service provision above that which is normally required under the core GP contract).

Compared to the England average, the practice has more young children as patients (age up to nine) and fewer older children (age 10 – 19). There are more patients aged 30 – 49, and fewer patients aged over 50, with more aged over 85 years than at an average GP practice in England.

Life expectancy of the patients at the practice is in line with CCG and national averages. The surgery is based in an area with a deprivation score of four out of 10 (1 being the most deprived), and has a higher level of income deprivation affecting older people and children. Compared to the English average, more patients are unemployed and have a long-standing health condition.

The practice operates from two surgeries, one in Sutton, Benhill Surgery which is in a converted residential premises with patient facilities on the ground floor.

The other surgery is situated in Belmont, this was purpose built in 1990. Both premises are accessible to patients in a wheelchair and those with pushchairs, there are baby changing and breast feeding areas available and a hearing loop.

The practice team at the surgery is made up of five GP principles, four salaried GPs and two GP registrars. Together the GPs provide 59 clinical sessions per week. The practice employs four part time female practice nurses and one part time female health care assistant. The non-clinical team consists of a practice manager, reception manager and seventeen administrative and reception staff.

The Benhill surgery opens between 8am and 6.30pm Monday to Friday. Appointments are available in two sessions daily, one morning and one afternoon. Extended hours appointments are offered from 7am to 8am on Mondays.

The Belmont surgery is open between 8.30am until 6.30 Monday to Thursday and 8.30am until 6pm Friday and is closed between 1pm and 2.30pm daily, however, the telephones are answered. Extended hours are provided 7am until 8am and 6.30pm until 8pm on Tuesday.

The provider has opted out of providing out-of-hours (OOH) services to their own patients between 6.30pm and 8am when the practice directs patients to seek assistance from the locally agreed out of hours provider.

The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of treatment of disease, disorder or injury, maternity and midwifery services, family planning, surgical procedures and diagnostic and screening procedures.

The practice is a training practice for doctors training to be GPs, and takes nurse practitioners and nursing students for placements.

This is the first time that the CQC has inspected the practice.

Updated 21 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Benhill and Belmont GP Centre on Wednesday, November 09, 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. The clinical waste bin was not securely stored at the main site.
• 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, with the exception of infection control training for two GPs.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. The practice had developed a patient charter which described what patients could expect from the practice and what patients needed to do to support the practice to enable them to provide the standards of care set out in the charter.
• 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 and the practice was waiting for building permission for a new building.
• 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:

• Review storage of patient notes at the branch practice to ensure it is secure.

• Review the storage arrangements for the clinical waste bin at the main site.

• Consider the risks when trialling new staff to ensure patients and their information is safe.

• Ensure staff acting as chaperone have training and are clear about their role and all staff complete infection control training.

• Ensure patients have access to complaint forms.

• Consider informing patients of the availability of translation services.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 21 March 2017

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 there was a recall system in place to ensure regular medicine and condition reviews. Patients at risk of hospital admission were identified as a priority and care plans were used to support these patients to manage emergency situations and given support strategies to prevent attending hospital.

• Performance for diabetes related indicators was comparable to the national average.

• 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 21 March 2017

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. There was a flag system on the practice electronic records to identify families where there were concerns.

• Immunisation rates were relatively high for all standard childhood immunisations. The practice had a system to follow up children who missed appointments.

• 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 80%, which was comparable to the Clinical Commissioning Group (CCG) average of 82% 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, health visitors and school nurses.

Updated 21 March 2017

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

• Older patients had a named GP to support their care.
• The practice offered proactive, personalised care to meet the needs of the older people in its population. They provided a service to five nursing homes  and two residential homes (186 beds across the homes)where they carried out a weekly visit and other visits when required.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Updated 21 March 2017

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 provided extended hours two mornings and two evenings a week.

• 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.

Updated 21 March 2017

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

• 92% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average.

• Performance for other mental health related indicators was comparable to the national average

• 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.

Updated 21 March 2017

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 homeless people, travellers, asylum seekers, refugees 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.