Archived: Beaumont Villa Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Beaumont Villa Surgery on 2 February 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.
• 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.

• Risks to patients were assessed and well managed with the exception of the systems in place to manage some aspects of high risk medicines.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Feedback from patients about their care was consistently and strongly positive.

• 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 that 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.
• The practice used innovative and proactive methods to improve patient outcomes. For example the practice had recently employed a mental health practitioner. This was a decision made by the GPs at the practice to meet the increasing needs for support for the patients with mental health problems.

We saw areas of outstanding practice:

• In response to audit findings about increased numbers of patients being diagnosed with mental health problems the practice had employed a mental health worker. This benefitted patients with more complex mental health needs as they had immediate access to higher levels of mental health expertise and experience. The practice planned to increase the overall availability of appointments for all patients experiencing mental ill-health, raise the quality of mental health referrals, broaden the skill mix of the practice and upskill other members of staff in this area. An additional benefit was to free up GPs time, enabling them to deal with the complex presentations of mixed mental and physical health problems (functional illness) which required longer appointments.

• There was a dedicated practice web site for the students. It is specifically designed for younger users and had a wealth of information and advice tailored to their needs: For example, sections on self-care for freshers, contraception and sexual health advice.

• The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability. Beaumont Villa covered a population with a very mixed socio-economic demographic and, for the southwest peninsula, an unusually diverse ethnic mix. It also had a high proportion of patients who were asylum seekers and refugees. Nearly all these patients required the use of the telephone translation service (Language Line). Data from Language Line showed that Beaumont Villa was responsible for more usage than any other practice in Devon, Cornwall and the Scilly Isles (DCIOS). Data showed 13.34% of calls made within DCIOS and 26.06% in Plymouth were made by the practice. The administration staff at the practice were experienced with helping patients who did not speak English as a first language. They offered double appointments for patients who spoke little or no English. They were aware of the other agencies that may be able to offer further help such as; Refugee Action, Devon and Cornwall refugee support. They signposted patients to other agencies when they needed help with translation, filling in forms and hospital appointment bookings.

The areas where the provider should improvement is:

• Ensure there is a robust system in place for the recall and search of patients on high risk medicines to have the necessary blood tests before repeat prescriptions are given.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice