• Doctor
  • GP practice

Archived: Practice 1, Medical Centre, Bridlington

Overall: Good read more about inspection ratings

The Medical Centre, Station Avenue, Bridlington, Humberside, YO16 4LZ (01262) 670683

Provided and run by:
Practice 1, Medical Centre, Bridlington

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Background to this inspection

Updated 28 December 2017

Practice 1, Medical Centre, Station Avenue, Bridlington is located in a Medical Centre and shares the building with two other GP practices. It is close to the town centre, the train station and local bus routes. Parking is available at the practice and on the street outside the practice, there are accessible facilities. Consulting and treatment rooms are all on the ground floor. The practice provides services under a Personal Medical Services (PMS) contract with the NHS North Yorkshire and Humber Area Team to the practice population of 5962, covering patients of all ages.

The proportion of the practice population in the 65 + and 75+ years and over age group is similar to the local CCG average and higher than the England average. In the 85+ age group the practice is similar to the local CCG and England average. The practice population in the under 18 years age group is similar to the local CCG and England average. The practice scored three on the deprivation measurement scale, the deprivation scale goes from one to ten, with one being the most deprived. People living in more deprived areas tend to have greater need for health services.

The practice has two GP Partners, both male and both work eight sessions per week. There is a female advanced nurse practitioner who works four days a week. There are three practice nurses and two health care assistants (HCA), all female and all work part time. There is a practice manager, a deputy practice manager and a team of administration, reception and secretarial staff.

The practice is open between 8.30am to 6pm Monday to Friday; telephone lines are open from 8am. Appointments with the GPs are available from 8.30am to 11am and 3pm to 5.20pm Monday to Friday. Appointments with the advanced nurse practitioner are available from 8.30am to 10.10am on Monday, 9am to 10.40am Wednesday to Friday and 3pm to 4.40pm Monday, Wednesday and Thursday and 12.50pm to 2.30pm on Friday.

The practice, along with all other practices in the East Riding of Yorkshire CCG area have a contractual agreement for the Out of Hours provider to provide OOHs services from 6.00pm on weeknights. This has been agreed with the NHS England area team.

The practice has opted out of providing out of hours services (OOHs) for their patients. When the practice is closed patients use the NHS 111 service to contact the OOHs provider. Information for patients requiring urgent medical attention out of hours is available in the waiting area and on the practice website.

Overall inspection

Good

Updated 28 December 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Practice 1, Medical Centre, Bridlington on 20 October 2017. 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 a system in place for reporting and recording significant events.
  • The practice had clearly defined and embedded systems to minimise risks to patient safety.
  • Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
  • Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their 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.
  • Patients told us they found it easy to make an appointment with a named GP and there was continuity of care, 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.
  • The provider was aware of and complied with the requirements of the Duty of Candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment).

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

Importantly the provider should:

  • Include review dates, actions required and who was responsible for ensuring actions were completed in significant events analysis (SEA) and complaint investigations.

  • Monitor the use of smartcards to confirm staff were following national guidance.

  • Monitor that recruitment checks are carried out in line with the practice policy.

  • Review the clinical audit programme to support the planning and completion of audit and quality monitoring cycles.

  • Improve the system for identifying carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

People with long term conditions

Good

Updated 28 December 2017

The practice is rated as good for the care of people with long-term conditions (LTCs).

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

  • Nationally reported data for 2016/2017 showed that outcomes for patients with long term conditions were good. For example, the percentage of patients with diabetes, on the register, in whom the last IFCCHbA1c was 64 mmol/mol or less in the preceding 12 months, was 94%. This was above the local CCG average of 83% and England average of 79%.

  • The Community Diabetes Specialist Nurse provided clinics at the practice to support staff in the management of patients with complex diabetes.
  • Longer appointments and home visits were available when needed.
  • Patients with LTCs had a named GP and a structured annual review to check that their health and medicines needs were being met. A pharmacist was supporting the practice staff with the review of patients medication at their annual reviews.

  • For those patients with the most complex needs, the named GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care.

  • Practice nurses visited patients at home to do long term conditions reviews and administer flu vaccinations during the flu season.

Families, children and young people

Good

Updated 28 December 2017

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 or who failed to attend hospital appointments.

  • Data from 2016/2017 showed childhood immunisation rates were high: for example, for immunisations given to children aged two the practice was achieving above the national expected coverage of 90% for vaccinations for the four indicators reviewed.

  • Children and young people were treated in an age-appropriate way and were recognised as individuals.

  • Nationally reported data from 2016/2017 showed the practice’s uptake for the cervical screening programme was 82%. This was comparable to the local CCG average of 84% and the England average of 81%.

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

  • Joint appointments were available for the post-natal mother and baby checks.

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

    The practice monitored any non-attendance of babies and children at vaccination clinics. The practice nurses contacted the parents of children who did not attend for vaccinations and worked with the health visiting service to follow up any concerns.

Older people

Good

Updated 28 December 2017

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. Patients over the age of 75 years had a named GP.

  • The practice had assessed the older patients most at risk of unplanned admissions and had developed care plans which were regularly reviewed.

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

  • The practice worked with the community care Elderly care Consultant and community teams to ensure older patients had annual reviews which included a review of medication by a pharmacist, clinical care and advanced care planning and discussion of ‘Do Not Resuscitate’ decisions.

  • Nationally reported data for 2016/2017 showed that outcomes were good for conditions commonly found in older people. For example, performance for heart failure indicators was 100%; compared to the local CCG average of 96% and the England average of 98%.

Working age people (including those recently retired and students)

Good

Updated 28 December 2017

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.

  • Telephone consultations were available every day with a call back appointment arranged at a time to suit the patient, for example during their lunch break.

  • The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.

People experiencing poor mental health (including people with dementia)

Good

Updated 28 December 2017

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

  • Nationally reported data from 2016/2017 showed 93% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the preceding 12 months. This was above the local CCG average of 85% and England average of 84%.

  • The practice carried out advanced care planning for patients with dementia.

  • Nationally reported data from 2016/2017 showed the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive care plan documented in their record in the preceding 12 months was 91%. This was comparable to the local CCG average of 92% and the England average of 91%.

  • The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

  • The practice sign posted patients experiencing poor mental health to 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 people with mental health needs and dementia.

  • The practice sign posted patients requiring support with drug and/or alcohol problems to counselling and support services.

People whose circumstances may make them vulnerable

Good

Updated 28 December 2017

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

  • The practice held registers of patients living in vulnerable circumstances which included those with a learning disability.

  • The practice offered longer appointments for people with a learning disability.
  • Nursing staff used easy read leaflets to assist patients with learning disabilities to understand their treatment.

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

  • The practice 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.

  • Telephone interpretation services were available.