Archived: Boundary House Surgery

Updated 8 January 2015

Boundary House Surgery was established over 30 years ago and occupies a purpose built premises in Bracknell. The practice provides medical services to approximately 8500 patients, with mixed deprivation scores. The practice serves a significant number of patients with young families.

The practice had recently been through some significant management changes. This was because three very experienced clinical staff had retired. This had impacted patients, who previously had benefited from a stable staff team for many years. The current management team were aware that patients and the practice staff needed time to adjust to the new members of the team, different working methods and styles.

Boundary House Surgery has a low number of patients registered who are over 65 and have a high proportion of under 18 patients registered with them, in comparison to local average.

Care and treatment is delivered by a number of GPs, practice nurses, health care assistants and phlebotomist. In addition, the practice is supported by the district midwives and midwives. Outside normal practice hours patients were able to access emergency care from an Out of Hours (OOH) provider.

The practice has a General Medical Services (GMS) contract and is also a GP training practice.

The practice provides services from:

Boundary House Surgery

Mount Lane

Bracknell

Berkshire

RG12 9PG

Updated 8 January 2015

Letter from the Chief Inspector of General Practice

We undertook a comprehensive inspection of Boundary House Surgery on the 1 October 2014. Overall we have rated the practice as good. We found all five domains were rated as good.

Our key findings were as follows:

The feedback received from patients was positive. Patients spoke positively about the practice staff and described them as friendly, supportive, efficient and caring. The practice results for the national GP patient survey 2013 were higher than the clinical commissioning group (CCG) and national average. Ninety two per cent of patients rated their experience of making an appointment as good and 97% patients said their last appointment was convenient.

We found the service was responsive to patient’s needs. The practice understood the needs of the practice population and had systems in place to meet their needs. Patients we spoke with were generally happy with the appointment system.

However, there were also areas of the practice where the provider needs to make improvements.

Importantly, the provider should:

• Ensure risk assessments are documented to confirm whether all members of staff required a criminal records check using the Disclosure Barring Service (DBS).

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice

Updated 8 January 2015

Patients with long-term conditions were seen at the practice and supported to manage their health, care, and treatment. The practice held regular clinics for long terms conditions such as diabetes and coronary heart disease. These clinics were led by the nurses, who were able to get immediate support from GPs if they found anything of concern. We found referrals to specialist such as endocrinologist were made in a timely manner and in line with local pathways. This ensured patients were able to get the support and treatment they needed. All patients with long term conditions were offered on the day appointments. Care for patients with several long term conditions was streamlined to ensure they were able to conduct all appropriate tests in on one visit. Disease registers were maintained that identified patients with long term conditions. There were recall systems in place to ensure patients with long term conditions received appropriate monitoring and support.

Updated 8 January 2015

The practice ran various clinics to support this patients group. These included antenatal clinics, postnatal care, childhood vaccinations & immunisations, sexual health and family planning. The practice achieved 98% on their child immunisation compared to a national average of 95%. All patients under age of five years were seen by GP and offered on the day appointment. The practice had good working relationship with the local Child and Adolescent Mental Health Teams (CAMHS).

Updated 8 January 2015

Overall the practice provided good quality care to older patients. The practice worked well with external organisations in delivering care to older patients, including palliative and end of life care. All patients who were 75 years of age and over had a named GP. Home visits were arranged for frail and elderly patients. Flu jabs were offered to elderly patients and the uptake was good. The premises and services had been adapted to meet the needs of the older and frail patients.

Updated 8 January 2015

The practice provides a range of appointments between 8:00am and 6pm Monday to Friday. The practice offered evening appointments to accommodate this patient population group. The practice also offered telephone consultations and offered advice via email. Alternative systems were introduced to allow all patients who were unable to attend the practice due to work commitments to book appointments and order their prescriptions online.

Updated 8 January 2015

Patients with mental health care needs were registered at the practice. Patients with needs related to substance misuse attended the practice and were referred to external organisations for further support. The practice had good working relationship with the local Community Mental Health Team (CMHT).

Updated 8 January 2015

There were no barriers for patients in vulnerable circumstances. People wishing to register at the practice were always accepted. The practice maintained a learning disability register and these patients received an annual review. The practice had comprehensive safeguarding policies and Mental Capacity Act 2005 (MCA) procedures. We found that staff were familiar with these. All staff had received safeguarding training. The practice provided medical services in a safe way to local groups who were particularly vulnerable.