West Walk Surgery

Updated 13 July 2016

West Walk Surgery, Yate West Gate Centre, 21 West Walk, Yate, Bristol BS37 4AX is situated in the town centre of Yate, South Gloucestershire. The practice has a small branch surgery, known as Coalpit Heath Surgery, located at 3 Church Lane, Coalpit Heath, Bristol, BS36 2SR, 3 miles away from the main practice. Overall, the practice had approximately 13,100 registered patients from Yate and the surrounding areas. West Walk Surgery serves approximately 85% and Coalpit Heath 15% of the practice population. The majority of the patients attending the Coalpit Heath Surgery were of the older age group.

The West Walk Surgery is located in purpose built premises, in an NHS Health Centre that provides health care to the local community. The practice is situated on the first floor of the building and is accessible by lift or stairs. There is a central patient waiting room with a reception desk with consulting and treatment rooms leading off these areas. Administration, management and meeting rooms are located in the shared space on the 2nd floor of the building. The practice has a primary medical service contract with South Gloucestershire Clinical Commissioning Group.

The practice supported patients from all of the population groups such as older people, people with long-term conditions, mothers, babies, children and young people, working-age population and those recently retired; people in vulnerable circumstances who may have poor access to primary care and people experiencing poor mental health.

Over 35% of patients registered with the practice were working aged from 15 to 44 years, 25.6% were aged from 45 to 64 years old. Just below 13% were over 65 years old. Around 7.5% of the practice patients were 75-84 years old and 2.8% of patients were over 85 years old. Just above 16% of patients were less than 14 years of age.

The practice consisted of seven GP partners and two salaried GPs. Of these nine GPs there were four male and five female GPs. There was a nurse manager and deputy nurse manager with four practice nurses and three health care assistants all of whom provided health screening and treatment five days a week. There were additional clinics implemented when required to meet patient’s needs such as the undertaking of influenza vaccinations. There was a team of administration, reception and secretarial staff. The practice had a full time practice manager who was in charge of the day to day management of the service.

West Walk Surgery had core hours of opening from 8.30am to 6.30pm every weekday. They did offer some appointments outside of these core hours such as from 7.30 on some mornings with the nursing staff. There was a GP pre-booked appointment system on Monday and Tuesday evenings up to 8pm. The Coalpit Heath Surgery was open from 8.30am to 12.30am and 2pm to 5.30pm, Monday. On Tuesday and Thursday the practice was open mornings 8.30am to 12.30am and including Friday re-opened for 2pm to 5pm. Wednesday and Friday mornings the practice morning period closed slightly earlier at 12 midday. There was no afternoon surgery on Wednesdays. The Coalpit Heath practice was not open at weekends West Walk Surgery provided Saturday appointments.

The practice referred patients to NHS 111 and  BrisDoc for out of hour’s services to deal with any urgent patient needs when the practice was closed.

Updated 13 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at West Walk Surgery on 6 May 2015. Overall the practice was rated as good with requires improvement for the safe domain. During this inspection we issued a requirement notice. This notice was due to a breach of Regulation 12 of The Health and Social Care Act (Regulated Activity) Regulations 2014, Safe care and treatment, in that the provider must make improvements in order to ensure services were safe for patients. The requirement notice was for the practice to implement the necessary changes to ensure patients who used the service were protected against the risks associated with infection prevention.

We undertook this focused inspection on 8 June 2016 to follow up the requirement notice made under Regulation 12 of The Health and Social Care Act (Regulated Activity) Regulations 2014.

Our key findings across all the areas we inspected during this inspection were as follows:

• The practice had in place a regular programme and documented audits for infection control for both West Walk Surgery and Coalpit Heath Surgery.

• The practice had installed appropriate signage warning of the storage of dangerous gases, such as oxygen.

• The practice had undertaken a risk assessment at the Coalpit Heath Surgery for prevention of legionella as this was not in place at our last inspection.

• We found the practice had ensured that evidence for the proof of identity and recent photographsof staff employed, in line with the practices recruitment policy, were available.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 6 August 2015

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. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 6 August 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. 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. 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. Childhood immunisation rates for the vaccinations given to under twos ranged from 92.5% to 97.7% and five year olds from 100%. These were above or comparable to South Gloucestershire Clinical Commissioning Group (CCG)/National averages.

Updated 6 August 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. The practice had implemented named GPs to lead care and support to patients living in care or nursing homes.

Updated 6 August 2015

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. 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.

Updated 6 August 2015

The practice is rated as good for the care of people experiencing poor mental health (including people living with dementia). People experiencing poor mental health had received an annual physical health check. The percentage of patients diagnosed with dementia whose care had been reviewed with a face to face consultation during the last 12 months (98%) was above the national average of 83%.The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those living with dementia. It carried out advance care planning for patients living with dementia.

The practice had signposted patients experiencing poor mental health about how to access various support groups and voluntary organisations. Staff had received training on how to care for people with mental health needs and was planning to improve staff knowledge in supporting patients living with dementia.

Updated 6 August 2015

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 those with a learning disability. It had carried out annual health checks and offered longer appointments for people with a learning disability.

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