Bridge House Medical Centre

Updated 30 July 2015

Bridge House Medical Centre is located in Stratford upon Avon, South Warwickshire and provides primary medical services to patients. The practice covers Stratford upon Avon and villages of Hampton Lucy, Alderminster, Long Marston, Welford, Binton, Temple Grafton, Aston Cantlow and Wilmcote. The practice has seven GPs (four male and three female), one practice manager, nursing, administrative and reception staff. The practice is a training practice and has its own dispensary. There were 9695 patients registered with the practice at the time of the inspection.

The practice is open from 8am to 6pm Mondays to Fridays and is closed at weekends. Home visits are available for patients who are too ill to attend the practice for appointments. There is also an online service which allows patients to order repeat prescriptions, book appointments and update personal details.

The practice makes more appointments available for working people. There is a varied rota of early morning appointments from 7am to 8am and some evenings 6.30pm until 7.30pm. All of these appointments have to be booked in advance. During these extended hours the GPs do not have access to the support services that are usually available during normal working hours, such as practice nurses, administration and prescription requests.

The practice treats patients of all ages and provides a range of medical services. The practice provides a number of clinics such as disease management clinics which includes asthma, diabetes, heart disease and well woman, child and travel immunisation clinics. The practice does not provide an out-of-hours service but has arrangements in place to ensure patients receive urgent medical assistance when the practice is closed. If patients call the practice when it is closed an answerphone message gives the telephone number they should ring, depending on the circumstances. Information on the out-of-hours service is provided to patients.

Bridge House Medical Centre has a General Medical Services (GMS) contract. The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.

Updated 30 July 2015

Letter from the Chief Inspector of General Practice

We inspected this service on 5 March 2015 as part of our new comprehensive inspection programme.

The overall rating for this service is good. We found the practice to be good in the safe, effective, caring, responsive and well-led domains. We found the practice provided good care to older people, people with long term conditions, families, children and young people, the working age population and those recently retired, people in vulnerable circumstances and people experiencing poor mental health.

Our key findings were as follows:

• Patients were kept safe because there were arrangements in place for staff to report and learn from incidents that occurred. The practice had a system for reporting, recording and monitoring significant events over time.

• There were systems in place to keep patients safe from the risk and spread of infection.

• Evidence we reviewed demonstrated that patients were satisfied with how they were treated and that this was with compassion, dignity and respect. It also demonstrated that the GPs were good at listening to patients and gave them enough time.

• The practice had an open culture that was effective and encouraged staff to share their views through staff meetings and significant event meetings.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 30 July 2015

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

Updated 30 July 2015

Appointments were available outside of school hours and the premises were suitable for children and babies. The practice offered extended hours appointments for two mornings and two evenings a week for advanced booking. The practice also offered a number of online services, including booking and cancelling appointments, requesting repeat medicines, sending secure messages to the practice, viewing medical record and updating patient details.

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 attendances at the accident and emergency (A&E) department of the local hospital.

Updated 30 July 2015

The practice offered personalised care to meet the needs of the older people within its population. They provided a range of enhanced services such as dementia and end of life care. Nationally reported data showed that the practice performed well against indicators relating to the care of older people. For example, the practice maintained a register of patients in need of palliative care and held weekly multidisciplinary care meetings where all patients on the palliative care register were discussed.

The practice was responsive to the needs of older patients. They offered home visits and rapid access appointments for those with complex healthcare needs. Patients 75 years of age and over were offered annual health reviews. The practice had recently employed a nurse care coordinator for two days per week to oversee and coordinate the care of patients 75 years of age and over. This service had been developed in recognition of the higher than average number of elderly and frail patients registered with the practice.

Updated 30 July 2015

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 on-line appointments and repeat prescription services, as well as a full range of health promotion and screening clinics that reflected the needs of this age group.

The practice offered a number of online services, including booking and cancelling appointments, requesting repeat medicines, sending secure messages to the practice and updating patient details. The practice nurse had oversight for the management of a number of clinical areas, including immunisations, cervical cytology and some long term conditions. The healthcare assistant led the smoking cessation clinic in the practice.

Updated 30 July 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 those with a learning disability and dementia. It had carried out annual health checks for patients with a learning disability and most of these patients had received a follow-up. It offered longer appointments for these patients.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It confirmed that vulnerable patients were informed 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 both normal working hours and out-of-hours.

Updated 30 July 2015

The practice held a register of patients living in vulnerable circumstances including people with a learning disability. The practice was committed to meeting the needs of vulnerable people and provided a caring and responsive service for them. Alerts were placed on these patients’ records so that staff were aware they might need to be prioritised for appointments and offered additional attention such as longer appointments.