Background to this inspection
Updated
4 September 2018
The partnership of GPs registered as Fremington Medical Centre runs one registered location at the Fremington Medical Centre, which was inspected on 28 June 2018. This was a comprehensive inspection. The practice is located at:
Fremington Medical Centre
11-13 Beards Road
Fremington
Barnstaple
EX31 2PG
The practice provides a primary medical service to approximately 6900 patients of a diverse age group. The practice population is in the eighth deprivation decile for deprivation. In a score of one to ten the lower the decile the more deprived an area is. Particular areas of Barnstaple and the surrounding villages have higher levels of deprivation. There is a practice age distribution of male and female patient’s equivalent to national average figures. Average life expectancy for the area is similar to national figures with males living to an average age of 81 years and females to 84 years.
The partnership at the practice comprises of three GPs partners and an advanced nurse practitioner who is also a partner, they are supported by two part time salaried GPs Three of the GP partners are full time and one works part time at the practice. The team are supported by a practice manager, six practice nurses, five healthcare assistants and a full time clinical pharmacist. There are administrative and reception staff.
Fremington Medical Centre is an approved training practice providing vocational placements for GPs registrars. One GP partner is approved to provide vocational training for GPs, second and third year post qualification doctors. Teaching placements were due to commence for medical students and student nurses.
Patients using the practice also have access to community nurses, mental health teams and health visitors. Other health care professionals visit the practice on a regular basis.
The practice is open between 8am and 6:30pm Monday to Friday. GP appointments are available from 8.30 am. Early phlebotomy appointments are available between 8am and 8.30am for working patients. Extended hours opening is available every Monday Thursday from 6.30pm to 7.30pm. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments. Outside of these times patients are directed to contact the out of hour's service by using the NHS 111 number.
Updated
4 September 2018
This practice is rated as Good overall. (Previous inspection October 2014 – Good)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Good
We carried out an announced comprehensive inspection at Fremington Medical Centre on 28 June 2018. The inspection was a routine inspection part of our inspection schedule.
At this inspection we found:
- The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved processes.
- Patients gave strongly positive feedback at the inspection about staff treating them with compassion, kindness, dignity and respect.
- People’s individual needs and preferences were central to the planning and delivery of flexible tailored services. All patient feedback highlighted ease of access to the appointment system, on the day assessment and short waiting time for routine appointments. Extended hours were available enabling working patients and school children to access a range of services from the multi-disciplinary team.
- IT was used effectively to engage patients in conversations about developments at the practice including social network sites. Access to advice and support was accessible for patients on the practice website.
- There was a strong focus on continuous learning and improvement at all levels of the organisation. Proactive succession planning based on staff development and training of future GPs, doctors and practice nurses was reinstated.
- Staff were committed to working collaboratively using innovative and efficient ways to deliver more joined-up care to vulnerable patients who used services.
- There were two areas where the provider could increase the frequency of audit to build on the quality improvement systems and review how patients who could be at risk of stroke or heart attack are assessed.
We saw areas of outstanding practice:
The practice established and ran a quarterly health and well-being club. Vulnerable patients who were not yet engaged with services were able to attend for companionship, healthy living advice and access support. Early identification of long term conditions, such as, hypertension (high blood pressure) had been picked up when blood pressure checks were done. At the June 2018 club, 13 patients had their blood pressure checked resulting in four booked in for review at the practice.
A dedicated internet application was developed at the practice for staff. This provided real time information easy access about current national guidelines, policies and procedures, shared learning, news, links and contact names and services available to signpost patients to.
An area where the provider should make improvements is:
Review the frequency of clinical audit to build on the quality improvement systems focussed on patient safety and effective care.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice