Bearwood Medical Centre

Updated 19 May 2016

Bearwood Medical Centre was inspected on Wednesday 13 April 2016. This was a comprehensive inspection.

The main practice is situated in Bearwood, an area on the outside of Bournemouth in Dorset. There is also a branch practice at Winton (The Banks Medical Centre) in Bournemouth. The practice provides a primary medical service to 9,350 patients with a higher than average patient list of over 65 years, young families, the unemployed and patients with long standing health conditions.

The practice is a training and teaching practice for GPs in training, foundation doctors and medical students.

There was a team of five GPs partners, four female and one male and three salaried GPs. All worked part time. The whole time equivalent was 5.49 GPs. Partners hold managerial and financial responsibility for running the business. The team are supported by a practice manager, a nurse practitioner, four practice nurses, a health care assistant and additional administration staff.

Patients using the practice also had access to community nurses, mental health teams and health visitors and other health care professionals who visit the practice on a regular basis.

The practice is open between 8am - 6:30pm Monday to Friday. Appointments are offered between 8:30am to 1pm and 2pm to 6pm anytime within these hours. Extended hours are offered from 6:30pm to 8pm on a Tuesday evening at the Bearwood practice and 7:30am to 8am every Monday morning at the Bank practice.

Outside of these times patients are directed to contact the out of hour’s service by using the NHS 111 number.

The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

The practice had a Personal Medical Services (PMS) contract with NHS England.

Bearwood Medical Centre practice provides regulated activities from the main site at Knights Road, Bearwood, Bournemouth, Dorset BH 11 9ST and from a branch at The Banks Medical Centre, Wimborne Road, Bournemouth, Dorset BH3 7AT. During our inspection we visited the main site at Bearwood. We did not visit the other branch location.

Updated 19 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bearwood Medical Centre on 13 April 2016. Overall 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 an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they 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 said 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.

We saw areas of outstanding practice:

• Two of the practices GPs with specific British Medical Acupuncture Society qualifications supported a number of patients in their pain management over a range of conditions.

• The practice were the first practice in Dorset to run virtual specialist diabetes clinics in conjunction with their consultant diabetologist to support high risk patients.

• In response to increased patient numbers from Middle Eastern backgrounds the practice appointed a GP who spoke Arabic fluently to help communicate more effectively with these patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 May 2016

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.

• The practice held virtual specialist clinics with a diabetes consultant for patients with complex diabetes needs.

• The practice had on-line facilities for patients to self-report peak flow and blood pressure.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines 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.

• The practice provided acupuncture for chronic pain management.

Updated 19 May 2016

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 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, and we saw evidence to confirm this.

• The practice provided a full range of contraceptive services for families, including coil and implant fitting. This included emergency coil fitting for post-coital contraception.

• 81.4% of females eligible for cervical screening had received a smear test in the past 6 months. This was comparable to the national average of 81%.

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

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

Updated 19 May 2016

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.

• Longer appointment times were available to enable older patients with multiple ailments to be discussed in one visit.

• Nationally reported data showed that outcomes for patients at the practice were good for conditions commonly found in older patients.

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

• The practice offered a direct telephone line for use in emergencies.

• The practice is working towards full delivery of social prescribing, involving a non clinical team member providing lifestyle advice/assistance and liaising with the voluntary sector services, such as exercise classes.

• The practice has a carers lead who assists patients and carers and liaises with the social and voluntary service sector.

Updated 19 May 2016

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 reflects the needs for this age group.

Updated 19 May 2016

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

• 100% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was higher than the national average of 84%.

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

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

• The practice had told patients experiencing poor mental health about how to access 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 patients with mental health needs and dementia

Updated 19 May 2016

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 homeless people, travellers and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• The practice held regular ‘Better Together’ multi-disciplinary team (MDT) meetings with the district nurses, community matrons, community mental health teams (CMHTs), social and voluntary sector services to ensure holistic care.

• 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.

• In response to increased patient numbers from Middle Eastern backgrounds the practice appointed a GP who spoke Arabic fluently to help communicate more effectively with these patients.