Bottreaux Surgery

Updated 27 December 2018

The partnership of three GPs registered as Bottreaux Surgery runs one registered location and a branch surgery. We inspected both sites at this comprehensive inspection. The practice is located at:

Bottreaux SurgeryBoscastleCornwallPL35 0BG

Branch surgery:

Tintagel Medical Centre

Bossiney Rd

Tintagel

Cornwall

PL34 0AE

The practice group provides primary medical services to 4855 patients of a diverse age group. The practice population is in the fifth deprivation decile for deprivation. In a score of one to ten the lower the decile the more deprived an area is. The practice area covers a mixed socio-economic demographic, supporting frail older patients living in a care home in Tintagel. 42% of the practice population is over 65 years old and 77% of the total practice population have a long-term condition. There is a practice age distribution of male and female patient’s equivalent to national average figures. Average life expectancy for the area is slightly higher than the national figures with males living to an average age of 81 years and females to 86 years.

The partnership at the practice comprises of three GPs partners (one male and two female). The team are supported by a practice/business manager, two practice nurses who are independent prescribers, one advanced healthcare practitioner and two phlebotomists as well as clerical staff.

Bottreaux Surgery is an approved training practice providing vocational placements for GPs registrars. Two GP partners are approved to provide vocational training for GPs, second and third year post qualification doctors.

Patients using the practice also have access to community nurses, mental health teams and health visitors. Other health care professionals visit the practice regularly providing weekly physiotherapy and counselling clinics for patients (Addaction).

The practice is open between 8am and 6:30pm Monday to Friday. Branch surgery opening times are listed on the practice website. Patients can choose to attend Bottreaux Surgery or Tintagel Medical Centre for appointments and at a time to suit them. Across Kernow, access to extended services was only available at hubs based in Bodmin, Stratton, St Austell, Liskeard, Newquay, Falmouth and Truro. Staff at the practice directed patients to these access services with further information available on the practice website. Outside of these times patients are directed to contact the out of hour's service by using the NHS 111 number.

Flu clinics are held during the week throughout the Autumn and Winter as advertised on the practice website and in waiting rooms.

The practice is registered to provide the following regulated activities: Diagnostic and screening, Surgical procedures, Family planning services, Maternity and midwifery services and Treatment of disease, disorder or injury

Updated 27 December 2018

This practice is rated as Good overall. (Previous inspection January 2015 – Requires Improvement. Follow up inspection October 2015 - Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at Bottreaux Surgery, including the dispensary on 1 November 2018. We visited the branch surgery at Tintagel and inspected the dispensary there. The inspection was a routine inspection as part of our inspection schedule.

At this inspection we found:

• Despite national recruitment challenges for the primary medical services sector, the practice had successfully attracted a new GP partner to join Bottreaux Surgery practice.
• The practice was focussed on safety and had clear systems to manage risk across the practice so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved processes.
• Audit was an area for improvement for practice to routinely review the effectiveness and appropriateness of the care it provided.
• Care and treatment was always delivered according to evidence-based guidelines.
• All the feedback from 10 patients at the inspection was positive about staff treating them with compassion, kindness, dignity and respect.
• Patient feedback about the appointment system had been listened to. The practice had increased patient access to appointments employing a varied skill mix of staff and increasing the number of appointments available with the GP and nursing team.
• There was a strong focus on continuous learning and improvement at all levels of the organisation. Proactive succession planning based on staff development and training of future GPs, doctors and practice nurses was evident at this training practice.
• There was a proactive approach to preventing development of long term health conditions. For example, 226 patients within the pre-diabetic range received support and advice and were reviewed annually.

Areas where the provider should make improvements are:

• Review the security of blank prescriptions within the dispensaries so that it is in line with national guidance.

• Review infection prevention and control arrangements to promote patient and staff safety.

• Develop an overall quality improvement programme with regular audits carried out across all staff groups and services.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 27 December 2018

Updated 27 December 2018

Updated 27 December 2018

Updated 27 December 2018

Updated 27 December 2018

Updated 27 December 2018