Archived: The Easton Family Practice

Updated 19 February 2015

The Easton Family Practice, Charlotte Keel Health Centre, Seymour Road Easton. Bristol. BS5 0UA; is located a short distance from junction three of the M32 and close to Bristol city centre.

The practice is part of the Bristol Clinical Commissioning Group and has approximately 5,400 patients. The practice shares the Charlotte Keel Health Centre facilities with another practice. Facilities include seven consulting rooms, a phlebotomy room (for carrying out blood tests in) and shared reception and waiting areas, shared treatment rooms. There is level access into the practice and to all patient areas. Toilets are accessible with separate facilities for patients with disabilities and a baby changing area. Parking is available on site and close to the practice. There are a range of administrative and staff areas including a meeting area on the first floor of the building. There is lift access to the first floor. The practice is a registered GP training location.

There are two full time male partners in the practice and two part time female salaried GPs. There is one female registrar GP also working in the practice. In addition there are two practice nurses and a practice manager working in the practice. The practice manager supports 15 reception and administration staff. A business manager works one day a week to support the practice manager.

The patients come from a wide range of backgrounds, with at least 5% who require translation services which are located within the health centre. Approximately 38% of patients come from Black and other ethnic minority groups with about 20% of patients coming from Somali and North African cultural backgrounds. The patient list size is slowly increasing by around 2.5% yearly and is a predominantly a young population. Only 3% of patients are over 75 years. The area has high unemployment and social problems associated with inner city areas such as drug, alcohol use and substance misuse.

The practice has a Personal Medical Services (PMS) contract to deliver health care services, the contract includes enhanced services such as extended opening hours. This contract acts as the basis for arrangements between the NHS Commissioning Board and providers of general medical services in England.

The practice has opted out of providing out-of-hours services to their own patients. This is provided by another organisation and patients are directed to this service by the practice during out-of -hours.

Updated 19 February 2015

Letter from the Chief Inspector of General Practice

We carried out our inspection on 4th December 2014. We inspected The Easton Family Practice, also known as Charlotte Keel Health Centre as part of our new comprehensive inspection programme. The practice had not been inspected under our new methodology before and that was why we included them.

Overall we found the practice is rated as good. We saw examples of a safe, effective, caring, responsive and well-led practice. Patients reported high levels of satisfaction with the practice during our inspection and this was reflected in the comment cards we also received.

Our key findings were as follows:

• Access to the practice was good with urgent appointments being bookable on the day and less urgent appointments being bookable in advance. There was an online booking system available to patients.
• The GPs held individual patient lists which enabled patients to see a named GP of their choice for the majority of appointments.
• There were systems in place which ensured patient safety and prompt referrals to other services to ensure patients health was maintained or improved.
• The practice had systems in place which ensured a hygienic environment was maintained.
• Patients were treated with dignity and respect by a staff team who understood patients’ needs. A translation service was available in the practice to meet the needs of the local population.
• Communication within the practice and to other services outside the practice was effective.
• The leadership of the management team ensured staff were informed and supported to deliver safe and effective care to patients.

We saw several areas of outstanding practice including:

• The practice had access to, and used, an interpretation service based in the practice to help if communicate with patients who did not have English as a main language. This supplemented their access to the NHS language line and the ability of one GP to speak five languages.
• The practice provided a drop-in educational sessions about diabetes for patients who did not have English as a first language. Each session covered a different aspect of diabetes such as foot care, diet and eye care.
• The practice worked closely with and referred patients to a local service that assessed and meet the initial health needs of asylum seekers.
• One of the practice nurses in conjunction with a dietician, deliver a programme about diabetes to newly diagnosed patients with type II diabetes. This is provided across the Bristol area.
• The practice carried out joint patient consultations with local mental health teams and worked closely with drug addiction project workers to ensure better outcomes for patients.
• The practice had 401care plans in place for patients with complex needs.
• One of the practice nurses had identified a gap in patient recording which collated information about long term conditions. They developed a form for all staff to use, integrated it into the patient record system and shared with other local practices.

However, there was also an area of practice where the provider needs to make improvements.

The provider should:

Review their system for ordering medicines for the practice to ensure orders are made based on the needs of the practice.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 19 February 2015

The practice is rated as good for the care of patients with long-term conditions. There were emergency processes in place and referrals were made for patients whose health deteriorated suddenly. Longer appointments of up to 30 minutes and home visits were available when needed. All patients with long term conditions had a named GP and a structured annual review to check that their health and medication 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.

Updated 19 February 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 average for all standard childhood immunisations and reflected the transitory nature of the population. Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals. We saw evidence to confirm this. 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, health visitors and school nurses. Emergency processes were in place and referrals were made for children and pregnant women whose health deteriorated suddenly.

Updated 19 February 2015

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

Updated 19 February 2015

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. 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 19 February 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). All patients experiencing poor mental health had their care plan reviewed during regular multidisciplinary team and safeguarding meetings. The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with a diagnosis of a dementia.

Updated 19 February 2015

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 including homeless people, travellers and those with a learning disability. It had carried out annual health checks for people with a learning disability. It offered longer appointments for patients who were vulnerable and those with a learning disability. A specialist project worker for a drug addiction service provided appointments to patients one day each week and linked with practice staff to ensure improved outcomes for vulnerable patients.