Archived: Bilsthorpe Surgery

Updated 20 September 2016

Bilsthorpe Surgery is run by Dr Leah Robinson, a single handed GP who provides primary medical services to approximately 3,030 patients . 

The practice is located in the village of Bilsthorpe in Nottinghamshire and provides services to the surrounding villages.  The level of deprivation within the practice population is slightly below the national average.

Services are provided to patients from one site from a single storey purpose built building, which is  shared with the area district nursing service.

The clinical team includes one GP, two practice nurses and a health care assistant. Locum GPs also provide regular medical support to the practice. The clinical team is supported by reception and administration staff and a part time practice manager.

The practice holds the General Medical Services (GMS) contract to deliver primary medical services.

The practice is open from 8am to 6.30pm Monday to Friday.   Appointments are offered from 9am to 10am and from 3.30pm to 5.30pm. An open access clinic operates daily from 10am to 11am where patients are invited to sit and wait, or are provided with an approximate appointment time. 

The practice has opted out of providing out-of-hours services to its own patients. Patients requiring a GP outside of normal working hours are advised to contact the out of hours service provided by Central Nottinghamshire Clinical Services.

Updated 20 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Bilsthorpe Surgery on 15 December 2015. A breach of legal requirements was found, in that not all improvements from the infection control audit dated November 2015 had been actioned.

Also, appropriate recruitment checks through the Disclosure and Barring Service (DBS) had not been undertaken for reception and administrative staff. The practice had not formally assessed the risk of employing the members of staff, including those who may undertake chaperone duties to determine whether a DBS check was required.

Overall the practice was rated as good; in view of the above the practice was rated as requires improvement for providing safe services.

After the comprehensive inspection, the practice wrote to us to say what action they had, and were taking to meet the legal requirement in relation to the breach. 

We undertook a desk based review on 30 August 2016 to check that the provider had completed the required actions, and now met the legal requirements. We did not visit the practice as part of this inspection. This report covers our findings in relation to the requirement.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Bilsthorpe Surgery on our website at www.cqc.org.uk.

Our finding across the areas we inspected was as follows:

• The practice had taken appropriate action to meet the legal requirement.
• The practice is rated as good for providing safe services.
• The recruitment policy had been reviewed to ensure the practice obtained appropriate Disclosure and Barring Service (DBS) checks for all staff.
• A DBS check was obtained for all reception and administrative staff following the comprehensive inspection. 
• An action plan had been produced from the infection control audit dated November 2015, which showed that all areas requiring improvement had been completed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 February 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.

• Indicators to measure the management of diabetes were higher than local and national averages. For example, 99% percent of patients on the practice register for diabetes had received a seasonal flu vaccination.

• 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 medicines 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 18 February 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.

• The practice nurse delivered a weekly clinic for teenagers to discuss their health needs. This was timed to coincide with the school bus drop off.

• 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’s uptake for the cervical screening programme was 85.8% which was the same as the CCG average of 85.8% and marginally above the national average of 81.8%. Appointments were available outside of school hours and the premises were suitable for children and babies. Urgent appointments were available on the day.

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

Updated 18 February 2016

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of older people in its population.

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

• The practice worked effectively with the multi-disciplinary teams to identify patients at risk of admission to hospital and to ensure their needs were met. The percentage of people aged 65 or over who received a seasonal flu vaccination was 78.3% which was above the national average of 73.2%.

Updated 18 February 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. This included extended hours access and access to telephone consultations.

• The practice was proactive in offering online services and all GP appointments were offered through the online booking system

• Health promotion and screening was provided that reflected the needs for this age group.

Updated 18 February 2016

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

• 100% of patients with a mental health condition had a documented care plan in place in the previous 12 months. This was 19% above the CCG average and 11.7% above the national average. This was achieved with a 0% exception reporting rate.

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

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• It 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.

Updated 18 February 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 those with a learning disability.

• It offered longer appointments for people with a learning disability in addition to offering other reasonable adjustments.

• 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.