Archived: Avonmouth Medical Centre

Updated 14 May 2015

Avonmouth Medical Centre is sited in an industrialised area of Bristol. It has approximately 2600 patients registered with a majority ethnicity of White British. The practice provides services to Avonmouth which encompasses a dockland area.

The practice operates from one location:

Collins Street,

Avonmouth,

Bristol,

BS11 9JJ

The practice is made up of three partners, one GP, one nurse practitioner and the practice manager. The practice has a personal medical service contract and also has some additional enhanced services such as extended hours for pre booked appointments and unplanned admission avoidance. The practice is open on Monday 8am – 7.30pm and Tuesday to Friday 8am – 6.30pm.

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

Patient Age Distribution

0-4 years 5.64 % lower than Clinical Commissioning Group (CCG) average

5-14 years 9.85 % lower than CCG average

15-44 years 44.86 % lower than CCG average

45-64 years 26.51 % higher than CCG average

65-74 years 7.34 %

75-84 years 4.29 % higher than CCG average

85 years + 1.51 % lower than CCG average

Patient Gender Distribution

Male 55.22 % higher than CCG average

Female 44.78 % lower than CCG average.

0.31 % of patients lived in care homes which was lower than CCG average.

10.16 % of patients from Black and Minority Ethnic (BME) populations which was lower than CCG average.

The practice is in an area of high deprivation, with a higher than Clinical Commissioning Group average number of patients over 75 years.

Updated 14 May 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Avonmouth Medical Centre on 1 April 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, caring, responsive and effective services and for being well led. It was also good for providing services for the all the population groups.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.

• 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 (PPG).

• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand
• The practice had a clear vision which had quality and safety as its top priority. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

There were areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• Ensure that the staff recruitment process is applied to all staff and so protects patients against the risks of the employment of unsuitable staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 14 May 2015

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. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care. Patients diagnosed with long term conditions were supported through a range of clinics held for specific conditions such as, asthma, chronic obstructive pulmonary disease (COPD) and heart failure. Patients receiving palliative care, those with cancer diagnosis and patients likely to require unplanned admissions to hospital were added to the Out of Hours system to share information and patient choice with other service providers.

Updated 14 May 2015

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. Appointments were available outside of school hours, two appointment sessions blocked each afternoon for under 16 year olds with additional protected appointments for over 16 year olds.The premises were suitable for children and babies. The practice ensured parents were contacted if a child had not attended the practice for immunisations and there were systems to monitor and follow up children when they did not attend hospital appointments. We saw routine audits were carried out by the practice to highlight non-attenders for immunisations and other appointments.

Updated 14 May 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 14 May 2015

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 extended hours and the ‘out of area’ enhanced service.

Updated 14 May 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). 100% of people experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia. We saw evidence of the ‘Do Not Attempt Resuscitation’ decisions in place which had been reviewed to allow patients to change their mind. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations including MIND and SANE. Staff had received training on how to care for people with mental health needs and dementia.

Updated 14 May 2015

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 people, travellers and those with a learning disability.

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

The practice held a learning disability register. Patients were invited to the practice for annual health checks through a standard letter offering a 30 minute appointment with a practice nurse followed up with a 30 minute consultation with a GP. It offered longer appointments for patients with a learning disability because it incorporated annual health checks for other conditions such as heart disease.