Barton House Medical Practice Also known as Drs Payne, Robinson & Farrell

Updated 16 May 2018

Barton House Medical Practice is located in Beaminster, Dorset. The registered location is at;

Barton House, Beaminster, Dorset DT8 3EQ

There are 5,700 patients on the practice list and the majority of patients are of white British background. The practice is an approved GP training practice and a dispensing practice. There are three partners and one salaried GP. The GPs are supported by two nurses, a practice manager, dispensary manager, a nurse practitioner, an integrated care nurse practitioner, a healthcare assistant, dispensary staff and reception and administration staff.

The practice provides a wide range of services to patients, including asthma and diabetes clinics, chronic disease monitoring, cervical screening, childhood immunisations, family planning, smoking cessation and weight control clinics. Regulated activities include diagnostic and screening procedures; Treatment of disease, disorder or injury; Maternity and midwifery services; Surgical procedures.

The practice is open 8am to 6.30pm Monday to Friday.

Patients requiring a GP outside of these hours are advised to contact NHS 111 service. Telephone appointments are also available every Monday (except bank holidays), Tuesday, Wednesday and Thursday from 6.30pm to 7pm for those unable to attend during normal hours. Patients are able to be seen on the same day for urgent appointments. The practice has personal GP lists which means every patient has a named GP. 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 practice has a contract with NHS England to provide general medical services. The practice has a higher than national average percentage of its population over the age of 65. Deprivation levels for the area are lower than the national average.

Updated 16 May 2018

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection September 2015 – 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 Barton House Medical Practice on 15 March 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 had safe systems and processes in place within the dispensary and had improved the service based on patient need through the development of blister packs and a delivery service.
• 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.
• The practice had a focus on quality improvement and demonstrated improved prescribing practices as a result of prescribing audits.
• The practice had introduced an integrated nurse practitioner role that provided improved support for frail patients and carers.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• The practice had systems in place to identify carers and provide support to them.
• The practice had systems in place to obtain feedback from patients and had taken action on this.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Review how the temperatures of the vaccine fridges are monitored.
• Review the infection control lead’s training.
• Review systems to improve the results recorded for the uptake of childhood immunisations.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 12 November 2015

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 that their health and medication needs were being met.

For those patients with the most complex needs, the named GP worked with relevant health care professionals to deliver a multidisciplinary package of care.

Vulnerable patients were placed on the virtual ward register and discussed in the monthly virtual ward meetings that were attended by the GPs, District Nurses, Social Services, Mental Health Team as well as community and psychiatric consultants for the elderly. Care plans were produced for appropriate patients.

Updated 12 November 2015

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.

Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses. Monthly meetings were held to discuss vulnerable children.

Contraceptive services were provided by the GPs and one practice nurse in normal surgery appointments.

Updated 12 November 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people.

The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

All patients had a named GP.

The practice had an Integrated Care Nurse Practitioner whose role was to take holistic care of elderly patients through working closely with all agencies including medical, nursing, social services and mental health teams.

Monthly virtual ward multi-disciplinary meetings were held for vulnerable elderly patients. Community Consultants for the Elderly and Psychiatry for the Elderly attended in rotation.

Opportunistic screening of elderly patients for dementia, both in the practice and on home visits, was undertaken by the GPs and practice nurses.

Palliative care was provided through integration between GPs, nurses, community rehabilitation team and the palliative care nurse. Monthly Palliative Care meetings took place to facilitate the care of patients. The practice held a Palliative Care Register for end of life care.

Updated 12 November 2015

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.

Updated 12 November 2015

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

The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia.

The practice told patients experiencing poor mental health how to access various support groups and voluntary organisations. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

Updated 12 November 2015

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 children and those with a learning disability. It had carried out annual health checks and offered longer appointments for those people with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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.

The practice provided care and support for two residential units for patients with autism and related disorders on the autistic spectrum.

Vulnerable people on the Virtual Ward Register and Palliative Care Register are discussed in their respective monthly meetings.

Care plans are in place for vulnerable patients.