Background to this inspection
Updated
22 August 2016
Parishes Bridge Medical Practice is located in West Byfleet Health Centre, a purpose built centre which houses two other general practices, a pharmacy and other health services. The practice shares some facilities with the other practices in the health centre such as some waiting areas, the minor operations suite and the information and technology/building manager. District nurses, health visitors and midwives are based in the health centre which aids communication.
The practice is in a central location in West Byfleet near the railway station.
The practice operates from:
West Byfleet Health Centre
Madeira Road
West Byfleet
Surrey
KT14 6DH
There are approximately 11,000 patients registered at the practice. Statistics show very little income deprivation among the registered population. The registered population is lower than average for 20-34 year olds, and slightly higher than average for those aged 40-54 and those aged 65 and above.
The practice has five partners and three salaried GPs (one male and seven female). Four of the doctors work full time and the other four work part time. There are two practice nurses and two HCAs.
The practice is a training practice and there are regularly GP trainees working in the practice.
The practice is open from 8.00am to 6.30pm from Monday to Friday. Appointments are from 8.30am to 12pm and 3pm to 6pm. In addition the practice offers extended hours opening with appointments from 7am on Wednesdays. Patients can book appointments in person, by phone or on line.
Patients requiring a GP outside of normal working hours are advised to contact the NHS GP out of hours service on telephone number 111.
The practice has a General Medical Services (GMS) contract. GMS contracts are nationally agreed between the General Medical Council and NHS England.
Updated
22 August 2016
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Parishes Bridge Medical Practice on 5 July 2016. Overall the practice is rated as good.
Our key findings across all the areas we inspected were as follows:
- Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
- The practice provided safe and effective clinical care.
- 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.
- 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.
- 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.
- 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.
- The practice worked closely with the other two practices in the health centre to make best use of the facilities. It worked with the local community and hospitals to provide extended health services at a convenient location for patients.
- The practice was well organised and had motivated staff who worked well as a team
- 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 areas where the provider should make improvement are:
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
22 August 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.
- 88% of patients on the diabetes register had a record of a foot examination and classification which was in line with the clinical commissioning group (CCG) average of 89% and national average of 88%.
- 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.
Families, children and young people
Updated
22 August 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.
- 96% of eligible female patients had a cervical screening test which was better than the CCG average of 80% and national average of 82%.
- Appointments were available outside of school hours and the premises were suitable for children and babies.
- We saw positive examples of joint working with midwives and health visitors. The health visitors were based in the health centre alongside the practice which aided communication.
Updated
22 August 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 people in its population.
- The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
- The practice provided support for a number of care homes and the feedback from these homes was positive about the care patients received from the GPs.
- The practice identified older patients with complex health and social care needs for referral to the new locality hub that provided integrated care and a swift assessment by a multidisciplinary team at the local community hospital.
Working age people (including those recently retired and students)
Updated
22 August 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.
- The practice offered early morning appointments with GPs from 7am on Wednesdays
- A number of outpatient clinics were held in the same health centre which provided patients with a local alternative to travelling to hospital.
People experiencing poor mental health (including people with dementia)
Updated
22 August 2016
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).
- 75% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was lower than the CCG average of 83% and the national average of 84%.
- 93% of patients experiencing poor mental health had an agreed care plan, which was better than the CCG average 91% and national average of 88%.
- The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
- The practice carried out advance care planning for patients with dementia.
- The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
- 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.
- Staff had a good understanding of how to support patients with mental health needs and dementia.
- A local consultant psychiatrist ran a weekly community mental health outpatient clinic in the health centre.
- The practice had worked with the local community mental health team to review prevalence and coding of dementia diagnosis. The practice supported patients with dementia by offering longer appointments, dementia care planning, signposting of services and support for carers.
People whose circumstances may make them vulnerable
Updated
22 August 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.