Archived: Brickfields Surgery

Updated 23 April 2015

Brickfields Surgery is located on the town of South Woodham Ferrers, which is geographically situated within the borough of Chelmsford. The practice provides services for approximately 6,000 patients living in the town. The practice holds a General Medical Services (GMS) contract and provides GP services commissioned by NHS Mid Essex Clinical Commissioning Group.

The practice is managed by one two GP partners who are supported by clinical staff; two salaried GPs, one advanced nurse practitioner, three practice nurses, one healthcare assistant / phlebotomist. The practice also employs a practice manager, a business manager and a team of reception, clerical and administrative staff. The practice also employs a cleaner.

The practice is open from 7.30am to 6.30pm on weekdays. GP and nurse appointments are available from 7.30am on Mondays, Tuesdays and Wednesdays. Daily walk in clinics for urgent care and treatments are available daily from 9am to 11.30am. Routine appointments can be pre-booked up to four weeks in advance in person, by telephone or online. Home visits and telephone consultations are available daily as required.

The practice has opted out of providing GP services to patients outside of normal working hours such as evenings and weekends. During these times GP services are provided by Primecare Primary Care, an out-of-hours advice, emergency and non-emergency treatment service. Details of how to access out-of-hours advice and treatment is available within the practice, on the practice website and in the practice leaflet.

Updated 23 April 2015

Letter from the Chief Inspector of General Practice

We conducted a comprehensive announced inspection on 25 March 2015

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well-led services. It was also good for providing services for the older people, people with long-term conditions, families, children and young people, working age people (including those recently retired and students), people living in vulnerable circumstances, and people experiencing poor mental health (including people with dementia).

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed, addressed and shared with staff during meetings.
• Risks to patients and staff were assessed and managed. There were risk management plans in which included areas such as premises, medicines handling and administration, infection control and safeguarding vulnerable adults and children.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles. Staff were supervised and supported as needed and any further training needs had been identified and planned for.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. They told us that access to appointments with GPs and nurses was good and that they were happy with the treatments that they received.
• Information about services and how to complain was readily available and easy to understand. Complaints were handled and responded to in line with relevant guidelines.
• 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.

However, there were three areas of practice where the provider needed to make improvements.

The provider should

• Ensure that infection control audits in relation to minor surgical procedures are carried out to monitor incidents of infections and identify an infection control lead for oversight of infection control procedures within the practice.
• Ensure that staff who undertake chaperone duties undertake appropriate training in respect of this role.
• Carry out clinical audit cycles to monitor and improve, where needed, outcomes for care and treatment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 April 2015

This practice is rated as good for the care of people with long term conditions. The practice had effective arrangements for making sure that people with long term conditions were invited to the practice for annual and half yearly reviews of their health and medication to ensure that their treatment remained effective. Appointments were available with the practice nurse for annual health checks and reviews for long term conditions such as diabetes and respiratory conditions including asthma and chronic obstructive pulmonary disease (COPD). When needed, longer appointments and home visits were available. 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.

Patients had access to early morning appointments from 7.30am three mornings each week and daily walk in appointments were available for urgent treatments between 9am and 11.30am each day. Patients told us they were seen regularly to help them manage their health.

Updated 23 April 2015

The practice is rated as good for the population group of families, children and young people. Appointments could be booked in person or by telephone. Appointments could be booked up to four weeks in advance.

Information and advice was available to promote health to women before, during and after pregnancy. A full range of pre-conception, antenatal and postnatal care services was available with the community midwife with fortnightly appointments and clinics. The practice monitored the physical and developmental progress of babies and young children. Appointments were made available outside of school hours wherever possible.

There were arrangements for identifying and monitoring children who were at risk of abuse or neglect. Records showed that looked after children (such as those in foster care / under the care of the Local Authority), those subject to child protection orders and children living in disadvantaged circumstances were discussed, including any issues shared and followed up, at monthly multi-disciplinary meetings. GPs and nurses monitored children and young people who had a high number of A&E attendances or those who failed to attend appointments for immunisations and shared information appropriately. Staff were trained to recognise and deal with acutely ill babies and children and to take appropriate action.

There was information available to inform mothers about all childhood immunisations, what they are, and at what age the child should have them as well as other checks for new-born babies. Staff proactively followed up patients who failed to attend appointments for routine immunisation and vaccination programmes.

Information and advice on sexual health and contraception was provided during GP and nurse appointments.

Updated 23 April 2015

This practice is rated as good for the care of older people. Patients over the age of 75 years had a named accountable GP who is responsible for their care and treatment. The practice identified patients who were at risk of avoidable unplanned hospital admissions. These patients were included on the practice’s ‘unplanned admissions avoidance’ list to alert staff to people who may be more vulnerable. The GPs carried out visits to people’s homes if they were unable to travel to the practice for appointments. The practice provided a range of health checks for patients aged 75 years and over. Seasonal flu vaccination and shingles vaccination programmes were provided. Flexible appointments were provided, including longer appointments if needed and early morning appointments from 7.30am three mornings each week. The practice also offered walk in appointments for urgent treatment between 9am and 11.30am each day. Patients with one or more long-term medical condition in the over 75 years population group and those who were identified as being vulnerable were included on a frailty register and had individualised care plans, which were reviewed every three months by the patient’s named GP.

The practice identified people with caring responsibilities and those who required additional support which was recorded on their patient record. Patients with caring responsibilities were invited to register as carers so that they could be offered support and advice about the range of agencies and benefits available to them.

Updated 23 April 2015

The practice is rated as good for the population group 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. Appointments could be booked online, in person or by telephone. Appointments could be booked up to four weeks in advance. Appointments were available from 7.30am three days each week and walk in clinics were available from 9am to 11.30am each day for urgent care and treatment.

Information about annual health checks for patients aged between 40 and 75 years was available within the practice and on their website. Nurse led clinics were provided for well patient health checks. The practice provided travel advice and vaccination through appointments with the practice nurse team. Information on the various vaccinations available including diphtheria, tetanus, polio and hepatitis A was available on the practice website. When patients required referral to specialist services, including secondary care, patients were offered a choice of services, locations and dates. These referrals were made in a timely way and monitored to ensure that patients received the treatments they needed.

Updated 23 April 2015

The practice is rated as good for the population group of people experiencing poor mental health (including people with dementia). People experiencing poor mental health had received an annual physical health check. The practice regularly worked with multidisciplinary teams in the case management of people experiencing poor mental health including those with dementia. The practice provided dementia screening services and referrals were made to specialist services as required.

Patient referrals were made to appropriate services such as psychiatry and counselling, including The Improving Access to Psychological Therapies (IAPT) and referrals to child and adolescent Mental Health Services (CAMHS).

The practice had sign-posted patients experiencing poor mental health to various support groups and third sector organisations including MIND. Patients were referred to local counselling sessions where appropriate and patients were provided with information how to self-refer should they wish to receive counselling.

Updated 23 April 2015

This practice is rated as good for the care of people living in vulnerable circumstances. The practice had a register of patients who had learning disabilities. All patients with learning disabilities were invited to attend for an annual health check. The practice regularly worked with multidisciplinary teams in the case management of vulnerable people. The practice had sign-posted vulnerable patients to various support groups and third sector 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 and out-of-hours.