Background to this inspection
Updated
7 February 2020
Binfield Surgery is a purpose-built practice located in the semi-rural village of Binfield in Berkshire and provides GP services to over 11,500 patients. The practice is part of East Berkshire Clinical Commissioning Group (CCG) and a part of a federation of Bracknell and Ascot GP practices. In July, they became part of the Bracknell and district primary care network (PCN).
Binfield Surgery provides regulated activities from:
Terrace Road North
Binfield
Berkshire
RG42 5JG
Patients can access information and online services from the practice website: www.binfieldsurgery.co.uk
The practice is registered by the Care Quality Commission (CQC) to carry out the following regulated activities: diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures and treatment of disease, disorder or injury.
The practice population is predominantly white British with 8% of the patients from black and other minority ethnic groups. The practice is located within an area of high affluence and low deprivation with low levels of unemployment.
There are three practice partners (all male) and two salaried GPs (both female) as well as some regular locum GPs. The GPs provide 33 sessions per week between them and have a whole time equivalent of 4.5 full time GPs. The nursing team consists of four practice nurses and one health care assistant.
The day to day operation of the practice is undertaken by a Practice Manager, an assistant practice manager, a reception lead and deputy reception lead and eight reception and admin staff. There is also a repeat prescription clerk, a secretary and an ENT secretary.
Binfield Surgery provides dispensary services to approximately 290 patients who are unable to access a pharmacy within 1 mile of their home. The practice had commenced offering dispensary to services in January 2020 following six months of closure due to staffing issues. There are currently two qualified dispensary assistants (DA). A third DA, who will also be the Dispensary Manager, has recently been appointed and will begin training in January 2020.
One of the GP partners operates an ear, nose and throat (ENT) clinic on the premises. The ENT service is provided by Binfield Surgery and can be accessed by patients from Binfield Surgery and other local practices.
Patients can also access a sleep clinic provided by one of the GPs under a different provider organisation, which is facilitated at the practice outside core opening hours. The sleep clinic is not in scope for registration by the CQC and was not inspected during this inspection.
The practice has a General Medical Services (GMS) contract. (GMS contracts are between NHS England and general practices for delivering general medical services and is the most common form of GP contract).
This practice does not provide Out of Hours (OOH) services. Patients can access an OOH GP by contacting the NHS 111 service. Patients can also access an extended hours service provided by the federation of Bracknell and Ascot GPs each weekday evening from 6.30pm to 8.30pm, Saturdays from 8am to 2pm and some additional morning appointments on Sunday.
Updated
7 February 2020
We carried out an announced comprehensive inspection at Binfield Surgery on 8 January 2020 to follow up on concerns and breaches of regulation following our previous inspections in May 2019 and April 2018.
At the last inspection, in May 2019, we rated the practice as requires improvement overall. Specifically, we rated the practice as inadequate for providing well led services and requires improvement for providing safe and effective services. We also rated the population group ‘people experiencing poor mental health’ as inadequate and ‘people with long term conditions’ as requires improvement. We issued a warning notice for regulation 17: Good governance and two requirement notices for regulation 12: Safe care and treatment and regulation 18: Staffing.
We undertook a focused follow up inspection in September 2019, to follow up on the warning notice and check the practice had made improvements to their governance processes.
At this inspection (January 2020) we found that the provider had satisfactorily addressed our concerns.
We based our judgement of the quality of care at this service on a combination of:
- what we found when we inspected
- information from our ongoing monitoring of data about services and
- information from the provider, patients, the public and other organisations.
We have rated this practice as good overall and good for all population groups.
We found that:
- The practice provided care in a way that kept patients safe and protected them from avoidable harm.
- The provider had improved their dispensary processes and undertaken appropriate risk assessments to reduce risk.
- The practice had improved the quality of care for patients with poor mental health and long term conditions. They had worked with external stakeholders to ensure changes made were effective and sustainable.
- Staff dealt with patients with kindness and respect and involved them in decisions about their care.
- The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
- The practice had reviewed their governance processes and implemented an action plan to focus on specific areas of concern highlighted to them during the May 2019 inspection. There was improved oversight of patient care outcomes and effective management processes in place to reduce risk.
Whilst we found no breaches of regulations, the provider should:
- Continue to monitor, review and recall patients taking novel oral anticoagulants to improve their care and treatment outcomes in line with guidance.
- Complete the dispensary development plan to include a system for assessing competency for dispensary staff and audit tools to audit dispensary processes.
- Introduce a process for monitoring consent seeking processes, to ensure patient consent is gained in accordance with legislation and guidance.
- Review the use of translation services offered to patients who do not speak English as a first language. Encourage staff to use this facility.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care