Burton & Bransgore Medical Centres - Care Quality Commission

Background to this inspection

Updated 31 March 2017

Burton and Bransgore Medical Centres are made up of two practices. The main practice is situated in Burton, close to the coastal town of Christchurch, Dorset.

The deprivation decile rating for this area is nine (with one being the most deprived and 10 being the least deprived). The practice provides a primary medical service to approximately 8,800 patients of a diverse age group. The 2011 census data showed that the majority of the local population identified themselves as being White British with some pockets of populations from Asian and Chinese backgrounds. The mix of patient’s gender (male/female) is almost equal at 51% female and 49% male. Public health data showed that 3.9% of the patients are aged over 85 years old which is higher than the local average (CCG) of 2.8% and higher than the national average of 2.3%.

There is a team of two GPs partners, one female and one male; the partners are supported by one salaried GP. Some GPs work part time making the whole time equivalent 2.6. Partners hold managerial and financial responsibility for running the business. The GP team are supported by a practice manager, deputy practice manager, five nurse practitioners, four practice nurses, one health care assistant, a paramedic and additional administration staff.

Patients using the practice also have access to community nurses, mental health teams and health visitors who are based at the practice. Other health care professionals visit the practice on a regular basis.

The practice is open between the NHS contracted opening hours 8am and 6.30pm Monday to Friday. Appointments are offered anytime within these hours. Extended hours are worked on alternate Mondays from 6.30pm until 8.00pm; Tuesdays 7.30am until 8.00am and one Saturday morning per month on average. Outside of these times patients are directed to contact the out of hour’s service and the NHS 111 number.

The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments as well as online services such as repeat prescriptions.

The practice has a Personal Medical Services (PMS) contract with NHS England.

This report relates to the regulatory activities being carried out at:

Burton Medical Centre, 123 Salisbury Road, Burton, Christchurch, Dorset. BH23 7JN

and the branch surgery located at:

Bransgore Surgery, Ringwood Rd, Bransgore, Christchurch, BH23 8AD

We did not visit the branch surgery at this inspection.

Overall inspection

Good

Updated 31 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Burton and Bransgore Medical Centres on 24 February 2017. This inspection was to follow up on action taken after we inspected on 18 October 2016. At the inspection on 18 October 2016 the overall rating for the practice was requires improvement. The full comprehensive report on the October 2016 inspection can be found by selecting the ‘all reports’ link for Burton and Bransgore Medical Centres on our website at www.cqc.org.uk .

This inspection was an announced focused inspection carried out on Friday 24 February 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 18 October 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

Governance processes had improved through the introduction of:

Failsafe recruitment processes to ensure clinical staff and had undertaken appropriate disclosure and baring service (DBS) pre-employment checks.
Systems and processes to identify staff who required training and updated learning. All staff had received the training required to perform their roles.
Systems to ensure the effective management of emergency equipment, emergency medicines and medicines within GPs bags.
Changes to the processes to monitor and manage medicines which needed refrigeration.
Systems to monitor, review and recall patients prescribed with high risk medicines.
Systems to collect information, review and assist gather data for QOF performance. This had resulted in higher QOF achievements.
Administration time had been allocated for checking test results carried out by locum staff and staff on leave.
Systems for ensuring significant event and clinical meetings were minuted and shared with all staff.
New policies and processes to keep these under review.
There had been a reduction of GP hours at the practice. However, since the last inspection the practice had recruited an additional two nurse practitioners. The practice had also set up a ‘vulnerable patient team’ which consisted of a paramedic, practice nurse, healthcare assistant and administration staff. The team were being used to assess, review and arrange treatment for any vulnerable patients at the practice.
The practice had worked to increase the percentage of carers identified. The changes made had increased the numbers of carers from 1.6% to 2.5% of the practice population group.
The practice had promoted the NHS Friends and Family Test but had only received four results since December 2016. One test result included negative comments about the appointment system which had prompted a more detailed survey focussing on appointments.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice