Heywood Family Practice

Updated 7 April 2016

Heywood Family Practice is located in a semi-rural area of North Somerset. They have approximately 6900 patients registeredand are a dispensing practice.

The practice operates from one location:

1 Lodway GardensPillBristolNorth SomersetBS20 0DL

The practice is sited in a purpose built two storey building. The consulting and treatment rooms for the practice are situated on the ground floor. The practice has six consulting rooms, one for each GP Partner and one allocated for any trainee GPs on placement. There is a treatment room (for use by nurses, health care assistants and phlebotomy), four clinic rooms and a minor surgery room; reception and records room; and a waiting room area for both GPs and nurses. There is patient parking immediately outside the practice with spaces reserved for those with disabilities.

The practice is made up of five GP partners (male and female), two salaried GPs, a nurse practitioner and the practice manager, working alongside two qualified nurses and a health care assistant and a phlebotomist. The practice is supported by an administrative team made of medical secretaries, receptionists and administrators. The practice is open from 8am - 7pm Monday to Friday for on the day urgent and pre-booked routine GP and nurse appointments. On the day telephone consultations are available for every patient who requests a same day response. There is daily “Extended Hours” until 7.00pm and one weekly surgery starting at 7.30am for working patients.

The practice has a Personal Medical Services contract with NHS England (a locally agreed contract negotiated between NHS England and the practice) and has a contract to be a dispensing practice. The practice is contracted for a number of enhanced services including extended hours access, facilitating timely diagnosis and support for patients with dementia, patient participation, immunisations and unplanned admission avoidance.

The practice is a training practice and offers placements to medical students and trainee GPs.

The practice does not provide out of hour’s services to its patients, this is provided by BrisDoc. Contact information for this service is available in the practice and on the website.

Patient Age Distribution

5-14 years old: 10.39%

15-44 years old: 31.07%

45-64 years old: 27.92%

65-74 years old: 14.39%

75-84 years old: 8.44% - higher than the national average

85+ years old: 3.18% - higher than the national average

Patient Gender Distribution

Male patients: 50.12 %

Female patients: 49.88 %

Patients from BME populations: 1.92 %

Updated 7 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Heywood Family Practice on 23 & 24 February 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• 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 the skills, knowledge and experience to deliver effective care and treatment.
• Feedback from patients about their care was consistently and strongly positive.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. The practice worked in partnership with the Community Nurses, for example, with the shared care of patients in ‘Safe Haven beds’ (these are community based beds in nursing homes intended to prevent hospital admission).

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group. For example adjustments were made to the telephony service to improve access.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The practice had very 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.
• The provider was aware of and complied with the requirements of the Duty of Candour.

The areas where the provider should make improvement are:

• Ensure there is controlled access to the medicine keys.

• Ensure the audit process for prescriptions included any handwritten prescription forms.
• The practice should put a process in place for auditing minor surgery.
• Ensure access to the minor surgery room is restricted.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 7 April 2016

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had specialist training for the management of chronic disease and patients at risk of hospital admission were identified as a priority.

• The percentage of patients with chronic obstructive pulmonary disease who had a review undertaken including an assessment of breathlessness using the Medical Research Council dyspnoea scale in the preceding 12 months (01/04/2014 to 31/03/2015) was 97.76% compared to the national average of 89.9%.

• All these patients had a named GP and a structured annual review to check that 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.

• Longer appointments and home visits were available when needed.

Updated 7 April 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. The practice worked in partnership with other practices to provide a minor illness educational programme for parents to reduce these 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.

• Appointments were available outside of school hours and the premises were suitable for children and babies. The practice had a dedicated play room for children to access when waiting for appointments.

• We saw good examples of joint working with midwives, health visitors and school nurses, for example, the GPs worked collaboratively with the midwives and completed 36 week checks for them.

Updated 7 April 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 patients in its population.

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

• The practice worked in partnership with the Community Nurses, for example, with the shared care of patients in ‘Safe Haven beds’ (these are community based beds in nursing homes intended to prevent hospital admission).

• The practice cared for patients in a nursing home and a care home for patients living with dementia. GPs provided weekly review visits and offer a rapid emergency service.

Updated 7 April 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 a ‘well woman’ clinic between 4pm-6pm every Monday.

• There were daily “Extended Hours” until 7.00pm and one weekly surgery starting at 7.30am for working patients.

• The practice hosted regular drug and alcohol counselling and worked in partnership to provide shared care.

Updated 7 April 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice undertook mini mental state examinations and blood screening for contributory illnesses before referral to the North Somerset Dementia diagnosis service. They worked in partnership with the Alzheimer’s Society, to offer access to Memory clinics which had a trained counsellor for patients and their carers. 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 organisation.

• 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.

• The practice had a lead GP to support patients with mental health needs and dementia. The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months (01/04/2014 to 31/03/2015) was 94.74% and the national average was 88.47%.

Updated 7 April 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 homeless patients, travellers and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients.

• The practice had told 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.