Archived: Dr Catherine Louise Leach Also known as Catherine Cottage Surgery

Updated 10 March 2016

Dr Catherine Louise Leach, known as Catherine Cottage Surgery, is the last single handed GP practice in the city of Bath, within the Bath and North East Somerset area.

The practice is located at:

21 Catharine Place, Bath, BA1 2PS.

The location is close to the centre of Bath with no car park and restricted metered parking in the surrounding streets. There are good transport links to the centre of Bath.

The practice has a population of 1700 patients with a mix of patients living in the city centre and the suburbs. The practice covers areas of mixed social deprivation. The Practice provides a session every morning and every afternoon except Tuesdays when a neighbouring surgery provides cover, and offers a monthly Saturday surgery. There is one female GP available Monday to Thursday and a male GP on a Friday. The GPs are supported by a part time practice nurse, three reception and administration staff and a part time practice manager.

The practice is open between 8am and 6pm Monday to Friday. Appointments are from 9am to 11.10am every morning and can extend from 1.30pm to 5.50pm daily, except Tuesday afternoons when a neighbouring practice covers for urgent appointments. Extended hours surgeries are offered one Saturday per month from 10am to 1pm. The practice always ensures that patients who feel they need an urgent appointment are always seen that day.

When the practice is closed the practice has a local agreement with Bath Doctors Urgent Care to provide cover from 6pm to 6.30pm.

From 6.30pm to 8am and at weekends the practice Out Of Hours cover is provided by Bath Doctors Urgent Care, accessed via NHS 111.

Updated 10 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Catherine Louise Leach on 7 January 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.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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 good facilities and was 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 March 2016

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

• The GPs had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• The percentage of patients with diabetes, on the register, who were achieving the target blood pressure was 90% compared to the national average of 78%.

• The percentage of patients with diabetes, on the register, who have had influenza immunisation in the preceding 12 months was 100%, compared to the national average of 94%.

• The percentage of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months was 96%, compared to the national average of 88%.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a annual review where the GP would offer a longer appointment to review all their long term conditions in one appointment. 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 GPs met fortnightly with the community matrons and weekly with the palliative care nurses.

Updated 10 March 2016

The practice is rated as good for the care of families, children and young patients.

• 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 patients who had a high number of A&E attendances, the practice had introduced a system to monitor A&E attendances in under 18 year olds and was proactive in offering support to this group

• Immunisation rates were high for all standard childhood immunisations.

• The practice’s uptake for the cervical screening programme was 84%, which was better than the national average of 81%.

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

• We saw good examples of joint working with midwives and health visitors.

Updated 10 March 2016

The practice is rated as good for the care of older patients.

• The practice offered proactive, personalised care to meet the needs of the older patients in its population.

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

• The GP took a very active role to support families who had experienced bereavement. The GP would call or visit at a flexible time and location to meet the family’s needs and give them a bereavement pack with practical help, signposting and advice. The GP also followed up the patients that were the most vulnerable, including a visit a few weeks after bereavement and before Christmas in their first year of their loss.

• The GPs were proactive in monitoring the patients in a local care home and completed regular reviews of the patients’ needs, including regular cognitive impairment tests to check for changes in memory and mood.

• The practice would ring patients with memory problems prior to their appointment time, to remind them of appointments to the surgery and to meetings with secondary care.

Updated 10 March 2016

The practice is rated as good for the care of working-age patients (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 the practice offered a monthly Saturday surgery following feedback from patients.

• 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.

Updated 10 March 2016

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

• 91% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months.
• The percentage of patients with serious mental health problems who had a comprehensive, agreed care plan documented in their record, in the preceding 12 months was 94% compared to the national average of 89%
• The percentage of patients with serious mental health problems whose alcohol consumption has been recorded in the preceding 12 months was 100% compared to the national average of 89.6%
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• It 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.
• It 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, and would ring patients if required to remind them of appointments at the practice or hospital.

Updated 10 March 2016

The practice is rated as good for the care of patients whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances and had a system in place to identify these patients. Any patients who may be experiencing any vulnerable circumstances were offered longer appointments, opportunistic health checks and immunisations

• It offered longer appointments for patients with a learning disability and they had all undergone a yearly health check

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

• 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.