Archived: Dr Burlein and Partners

Updated 2 December 2016

Dr Burlein and Partners is located on the peninsula of Gosport, known locally as Gosport Medical Centre, Bury Road, Gosport, and Hampshire, PO12 3AQ.

Dr Burlein and Partners, known as Gosport Medical Centre, provides primary medical services to around 9,200 patients in Gosport in an area of average deprivation compared to the rest of England. Less than 1% mixed of the patient population are from Asian and Indian ethnicities, with the majority of the practice population identifying themselves as White British.

There are four GP partners with one trainee GP called a registrar who together provide 4.5 whole time equivalent GPs, a total of 44 GP sessions per week. This is a mix of two male and two female GPs.

There are currently three practice nurses, one nurse practitioner, one treatment room nurse and one health care assistant. At the time of our inspection, the practice had just appointed a clinical pharmacist to assist with complex medicine issues for five sessions per week.

Dr Burlein and Partners is a training practice based in Gosport Medical Centre located behind a community hospital. This is a purpose built health centre built in 2010, containing a suite of rooms for assessing patients located off of the main reception area. The reception is light and airy with several noticeboards displaying a range of information for patients. GP clinical rooms are located off of one corridor and there is a lift to the second floor where nurse treatment rooms are located.

The clinical staff are supported by a practice manager who manages the 18 part-time clerical, reception and administrative staff, including an apprentice. The practice also trains student nurses and qualified nurses who are training to specialise in practice nursing.

The practice is open between 8.00am and 6.00pm Monday to Friday. Appointments are from 8.30am to 6.30pm daily. Extended hours appointments are offered until 7.45 pm on Monday and Thursday evenings. GPs and nurses offer telephone consultations with a triage clinic to assess patient’s needs held every morning and an emergency clinic held every afternoon.

When the practice is closed, the public are encouraged to use the NHS 111 service.

There has been no previous CQC inspection for this provider.

Updated 2 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Burlein and Partners on 23 August 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. For example, emergency systems were tested to allow staff to practise use of equipment.
• There was a commitment to improving patient safety in the practice shown by the practice’s scenario testing of emergency procedures and additional safety training by one GP to share learning across the organisation.
• 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 concerns. The practice had gathered feedback from patients through the Patient Participation Group (PPG) who were involved in trying to reduce non attended appointments.
• 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.
• The practice was a ‘Dementia Friendly Surgery’. An external dementia advisor was available in the practice once a week from 10am until 12 noon. The advisor provided a face to face support service for patients with dementia and their families.

• The training ethos of the practice meant that they are able to support student nurses and newly qualified nurses to understand primary care practice and study a general practice nursing qualification.

The areas where the provider should make improvement are:

• Review infection control guidelines, in relation to the management of sharps.
• Encourage patients to attend, where efforts have previously failed, in order to ensure that patients are receiving care and support such as those with diabetes and high blood pressure or high cholesterol.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 2 December 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.
• Performance for diabetes related indicators was better than the national average. For example, the percentage of patients in whom the last blood pressure reading was within acceptable limits was 90%, which was higher than a local Clinical Commissioning Group average of 78% and a national average of 78%.
• 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 2 December 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. 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.
• The practice’s uptake for the cervical screening programme was 90%, which was higher than the CCG average of 77% and the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• There were monthly meetings with health visitors and the practice was part of the local “breastfeeding welcome” scheme, which aims to promote breastfeeding.

Updated 2 December 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 ensured older frail people were discussed at least every three months at the multi-disciplinary meeting. They worked closely with community staff to ensure care plans were in place to avoid admission to hospital.

Updated 2 December 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.
• There were text reminders for appointments and the option to cancel appointments via text.
• The practice offered a range of access options including, daily bookable telephone appointments, late night clinics and an e-consult service is planned within 3 months.

Updated 2 December 2016

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

• 100% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average of 84%.
• Staff had a good understanding of how to support patients with mental health needs and those living with dementia.
• The practice was accredited as “Dementia Friendly”.
• There was a dementia advisor, hosted within in the practice once a month from 10am until 12pm providing a face to face service for patients and families affected by dementia.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses whose alcohol consumption had been recorded in the preceding 12 months was 98%, which was comparable to a local CCG average of 93% and a national average of 89%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• The practice carried out advance care planning for patients living with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• A variety of counselling services was available at the practice.
• 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.

Updated 2 December 2016

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 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.