Background to this inspection
Updated
26 April 2016
Dr Susan Bellworthy is situated in South Ockendon, Essex and provides GP services to approximately 2500 patients living in the town.
Dr Susan Mathew is one of 34 practices commissioned by the Thurrock Commissioning Group. The practice holds a General Medical Services contract (GMS) with the NHS. This contract outlines the core responsibilities of the practice in meeting the needs of its patients through the services it provides.
The practice population has a slightly higher number of children aged 5 to18 years compared to the England average. It has a lower number of patients aged over 65 years and fewer patients over 75 years. Economic deprivation levels affecting children and older people are higher and unemployment levels are lower. There is a train station situated in Ockendon with direct trains into London Fenchurch Street and therefore, many patients are commuters.
The life expectancy of male patients is lower than the local average by two years. The life expectancy of female patients is the same as the local average. There are a comparable number of patients on the practice’s list that have long standing health conditions and a comparable number of patients with health-related problems in daily life than the average.
The practice is registered as a sole provider with the Care Quality Commission. The provider is in the process of merging with another provider in the locality and as such, GPs from that practice regularly hold surgeries at Dr Susan Bellworthy to ensure continuity of care for patients. The practices will retain their current premises.
The practice employs a practice nurse. Administrative support consists of a part-time practice manager and a number of reception and administrative staff.
The practice is open from 8:30am until 8:00pm on a Monday, 8:30am until 6:30pm on a Tuesday, Wednesday and Friday, and from 8:30am until 1:00pm on a Thursday. It is closed on a Thursday afternoon and on the weekends.
Surgery appointments are from 8:50am until 11:30am every weekday morning. On a Tuesday, Wednesday and Friday afternoon surgery runs from 3:00pm until 6:00pm. The surgery is closed on a Thursday afternoon. Dr Susan Bellworthy offers later appointments with a GP on a Monday evening until 8:00pm.
The practice has opted out of providing 'out of hours’ services which is now provided by Integrated Care 24, another healthcare provider. Patients can also contact the NHS 111 service to obtain medical advice if necessary. Patients could attend South Ockendon Health Hub on a Saturday and Sunday from 9:15am until 12:30pm for pre-bookable appointments with a GP or nurse
Dr Susan Bellworthy has not been inspected by the Care Quality Commission previously.
The practice is registered to provide the following regulated activities: family planning; treatment of disease, disorder or injury; diagnostic and screening procedures; Maternity and midwifery services. The provider is not registered to, and does not provide surgical procedures or maternity and midwifery services. Maternity and midwifery services are provided at The Compass Centre, Barley Gardens, South Ockendon, where the Community Midwife provides a clinic to monitor women throughout the term of their pregnancy.
Updated
26 April 2016
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Dr Susan Bellworthy on 22 February 2016. Overall the practice is rated as Requires Improvement.
Our key findings across all the areas we inspected were as follows:
- There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
- Not all risks to patients were assessed.
- Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
- Patients said that they were happy with the service provided, and praised the GPs and nurses. There were a small number of patients who raised concerns about their involvement with the GP during consultations.
- Patients said they found it easy to make an appointment with a named GP and that 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 sought feedback from staff and patients, which it acted on.
The areas where the provider must make improvement are:
The areas where the provider should make improvement are:
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Put in place suitable arrangements to track prescription stationery through the practice.
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Effectively manage any risks identified at the premises.
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Make available translation services.
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Provide safeguarding training to all relevant staff.
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Carry out an audit in relation to the prevalence of Coronary Heart Disease to establish the cause of this outlier.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
26 April 2016
The practice is rated as requires improvement for the care of people with long-term conditions overall. The provider is rated as requires improvement for safe and caring. The concerns which led to this rating apply to everyone using the practice, including this population group.
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Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
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Longer appointments and home visits were available when needed.
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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.
Families, children and young people
Updated
26 April 2016
The practice is rated as requires improvement for the care of families, children and young people. The provider is rated as requires improvement for safe and caring. The concerns which led to this rating apply to everyone using the practice, including this population group.
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Immunisation rates were relatively high for all standard childhood immunisations.
- 87% of patients diagnosed with asthma had received an asthma review in the last 12 months. This was better than the local average of 75%.
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There were policies in place to safeguard children from abuse and contact telephone numbers for safeguarding authorities were accessible to reception staff, although not all staff had received relevant training.
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Appointments were available outside of school hours and the premises were suitable for children and babies.
Updated
26 April 2016
The practice is rated as requires improvement for the care of older people overall. The provider is rated as requires improvement for safe and caring. The concerns which led to this rating apply to everyone using the practice, including this population group.
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The practice offered personalised care to meet the needs of the older people in its population.
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47% of patients aged 60-69 had been screened for bowel cancer in the last two and a half years. This was lower than the local average of 54%.
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The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
Working age people (including those recently retired and students)
Updated
26 April 2016
The practice is rated as requires improvement for the care of people working age people overall. The provider is rated as requires improvement for safe and caring. The concerns which led to this rating apply to everyone using the practice, including this population group.
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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.
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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.
- 81% of women aged 25-64 had had a cervical screening test performed in the preceding 5 years. This was comparable to the national average of 82%.
People experiencing poor mental health (including people with dementia)
Updated
26 April 2016
The practice is rated as requires improvement for the care of people with poor mental health (including people with dementia) overall. The provider is rated as requires improvement for safe and caring. The concerns which led to this rating apply to everyone using the practice, including this population group.
- 78% of patients diagnosed with dementia who had had their care reviewed in a face to face meeting in the last 12 months, which was a little below the national average of 84%.
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All patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in their record. This was better than the national average of 88%.
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The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
People whose circumstances may make them vulnerable
Updated
26 April 2016
The practice is rated as requires improvement for the care of people whose circumstances may make them vulnerable overall. The provider is rated as requires improvement for safe and caring. The concerns which led to this rating apply to everyone using the practice, including this population group.
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Patients with a learning disability were identified and had an annual review. The practice offered longer appointments for these patients and provided an easy-read care plan.
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Carers were identified and a protocol was in place so that their needs could be met.
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The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
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The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
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There were policies in place to safeguard vulnerable adults from abuse and contact telephone numbers for safeguarding authorities were accessible to reception staff although not all staff had received relevant training.