Bushloe Surgery

Updated 12 November 2015

Bushloe Surgery is a GP practice which provides a range of primary medical services to approximately 10,000 patients from a surgery in the town of Wigston in Leicestershire. The practice’s services are commissioned by East Leicestershire and Rutland Clinical Commissioning Group (CCG).

The service is provided by five GP partners, three salaried GPs, a nurse practitioner, four practice nurses, and three health care assistants. They are supported by a practice manager, an assistant practice manager and reception and administration staff. There are both female and male GPs and the whole time equivalent (WTE) of GPs is 4.8.

The practice has a General Medical Services Contract (GMS). The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.

Local community health teams support the GPs in provision of maternity and health visitor services.

The practice has one location registered with the Care Quality Commission (CQC). The location we inspected was Bushloe Surgery, Two Steeples Medical Centre, Abington Close, Wigston, Leicestershire. LE18 2EW.

The surgery is in a new two storey building with a large car park which includes car parking space designated for use by people with a disability. Patient facilities were on the ground and first floor. The practice relocated to the new building in September 2014.

We reviewed information from East Leicestershire and Rutland Clinical Commissioning Group and Public Health England which showed that the practice population had much lower deprivation levels compared to the average for practices in England.

The main surgery is open between 08.00am and 6.30pm Monday to Friday with extended opening hours on Mondays until 8.30pm and Tuesdays from 7.30am to 8.00am.

The practice has opted out of the requirement to provide GP consultations when the surgery is closed. The out-of-hours service is provided to Leicester City, Leicestershire and Rutland by Central Nottinghamshire Clinical Services.

Bushloe Surgery is a training practice for trainee GPs.

Updated 12 November 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bushloe Surgery (Two Steeples Medical Centre) on 22 April 2015. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• 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 but information on the website should be more accessible.
• Patients said they didn’t always find it easy to make an appointment with a named GP but continuity of care was good, with urgent appointments available the same day.
• The practice had 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.

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

Importantly the provider should :

• Ensure recruitment arrangements include all necessary employment checks for all staff.
• Ensure the emergency medicines are stored securely at all times.
• Ensure outstanding actions identified in legionella risk assessment are completed.
• Ensure cleaning schedules are in place.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 12 November 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. Patients in this group had a structured annual review, either in the practice or at a patient’s home if necessary, to check that their health and medication needs were being met. For those people with the most complex needs, the GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care such as the community pharmacist and matron who visited vulnerable or chronically ill patients in their homes to assess needs and facilitate provision of any equipment, mobility or medication and assessed social needs.

Updated 12 November 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. Appointments were available outside of school hours. The practice worked closely with the local health visiting team and held multi-disciplinary team meeting at the practice to discuss children and families where there were safeguarding or other concerns.

The practice had facilities for baby changing & breast feeding available. Home visits were offered for 24 hour baby checks.

Updated 12 November 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 dementia and end of life care with regular multi disciplinary palliative care meetings.

The practice was responsive to the needs of older people, and offered a home visiting service for housebound patients, with a focus on timely and prompt visits. Care plans were in place for all nursing home patients. C arers were actively identified and additional support was available for them through community services offered. Patients could order medication by telephone or on the internet and the practice worked with local pharmacies to have it delivered to patients’ homes. Patient records were flagged with either sensory impairment, length of appointment and requests for a downstairs consulting room if appropriate.

Updated 12 November 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. Evening and early morning appointments were available to pre-book in advance. A text reminder service to patients to remind them of their appointments was offered and routine telephone appointments and advice was available and could be booked in advance.

Updated 12 November 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). 60% of people experiencing poor mental health and 77% of patients with dementia had received an annual physical health check in the last year. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia and supported and helped facilitate in house mental health services.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. Clinical staff had received training on how to care for people with mental health needs and dementia.

Updated 12 November 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 those with a learning disability. It had carried out annual health checks for people with a learning disability and 76% of these patients had received a follow-up. It offered longer appointments for people 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 premises were purpose built and offered good disabled access.

Drug and alcohol use was assessed, and appropriate referrals to community services were encouraged. The practice were working with a local organisation to establish a food bank.

Interpreting services were available.