Archived: Briton Street GP Surgery

Updated 11 July 2016

Briton Street GP Surgery provides primary medical services to approximately 1,868 patients in Leicester City.

It is registered with the Care Quality Commission to provide the regulated activities of; the treatment of disease, disorder and injury; diagnostic and screening procedures; family planning, maternity and midwifery services and surgical procedures.

At the time of our inspection the practice employed a practice manager, assistant practice manager, a health care assistant, nine reception and administration staff, 2 practice nurses and one domestic.

The surgery is open from 8am until 6.30pm Monday to Friday. The practice provides extended opening hours until 7.30pm on a Friday. The practice is part of a pilot scheme within Leicester City which offers patients an evening and weekend appointment with either a GP or advanced nurse practitioner at one of four healthcare hub centres. Appointments are available from 6.30pm until 10pm Monday to Friday and from 9am until 10pm on weekends and bank holidays. Appointments are available by walk in, telephone booking or direct referral from NHS 111.

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

The provider is registered with the Care Quality Commission (CQC) to provide regulated activities at Briton Street GP Surgery, 5 Briton Street, Leicester, LE3 0AA.

The practice is an accredited yellow fever centre which is registered with NATHNaC (National Travel Health Network and Centre).

The practice is a training practice and delivers training to Foundation Year 2 Doctors (FY2). An FY2 is a fully qualified Doctor who is registered with the General Medical Council (GMC) who is training to become a GP.

The practice has an active patient participation group (PPG) which has been in place for four years who meet on a bi-monthly basis.

The practice has a higher population of patients between the ages of 15-29 years of age and also 45-59 years of age. 53.4% of the patient population have a long standing health condition.

The practice offers on-line services for patients including ordering repeat prescriptions, booking routine appointments and access to patient summary care record.

The practice lies within the NHS Leicester City Clinical Commissioning Group (CCG). A CCG is an organisation that brings together local GPs and experienced health professionals to take on commissioning responsibilities for local health services.

The practice is a member of a Federation called ‘Millennium’ within Leicester City CCG. A Federation is a group of GP practices that work collaboratively with a shared mission and vision to share best practice and provide a greater range of services for patients. The Federation has been successful in the provision of a clinical pharmacist working within the ten GP practices. The lead GP is the Deputy Chair of this Federation.

Updated 11 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Briton Street GP Surgery on 25 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 been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Childhood immunisation rates for the vaccinations given were higher than CCG/national averages.The practice attended regular meetings with health visitors.
• 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.
• The practice ensured all staff received regular appraisals. All members of staff received regular reviews of their performance which included a report and a rating.
• The practice is an accredited yellow fever centre which is registered with NATHNaC (National Travel Health Network and Centre).
• The provider was aware of and complied with the requirements of the duty of candour.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 11 July 2016

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.

• The practice participated in an admissions avoidance scheme and delivered personalised care plans and regular reviews for patients with a long term condition with a view to deliver more personalised care and to reduce emergency or unplanned hospital admissions.

• The practice allocated a ‘tracker’ who were non-clinical members of staff, to patients identified as vulnerable and at risk of unplanned admission to hospital. Their role was to contact patients on a monthly basis to ensure they had a point of contact in the practice and ensured patients’ needs were met. The tracker would also give patients advice on local support groups and organisations that may be helpful to them to ensure their social needs were met.

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

• The practice held bi-monthly Gold Standard Framework (GSF) meetings to review and discuss the needs of all palliative patients.

• There was a GP lead for patients who were at end of life.

• The practice held weekly meetings with District Nursing teams.

• In 2014-15, performance for diabetes related indicators was 58.8% which was lower than the national average of 89.2%. Performance in this indicator had significantly improved in 2015-16.

Updated 11 July 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. 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.

• The practice’s uptake for the cervical screening programme was 72.79%, which was higher than the CCG average of 68.9%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

• The lead GP had attended Gillick Competence and Fraser Guidelines training.

• The practice liaised with health visiting teams on a weekly basis.

• Midwifery led clinics were held in the practice eon a two weekly basis.

• The practice reviewed children whose appointment had not been attended and where there had been no notification of cancellation. Any concerns relating to these children were discussed with health visiting teams on a weekly basis.

Updated 11 July 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 people in its population.

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

• The practice participated in a care navigation scheme which provided a wide range of support to older people through home visits from a care navigator to help them remain healthy and to help patients carry on living in their own homes.

• Patients received personalised care plans from a named GP to support continuity of care.

• The premises were accessible to patients with mobility difficulties.

Updated 11 July 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. For example, extended hours appointments were available and online services such as ordering repeat prescriptions and appointment booking for the convenience of patients who worked or had other commitments during the day.

• 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.

• An automated arrival machine was available to give patients the opportunity to arrive themselves for their appointment rather than speak to a receptionist.

Updated 11 July 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 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 organisations.

• 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.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

• All clinical staff had attended Mental Capacity Act (MCA) training.

Updated 11 July 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 people, travellers and those with a learning disability.

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

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed 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.