Bartholomew Medical Group

Updated 1 March 2017

Bartholomew Medical Group based in Goole Health Centre is located on the Goole Hospital site in Goole, East Riding of Yorkshire. The practice has a branch site on Swinefleet Road in Goole, the main practice and branch site were visited during the inspection. It is part of the East Riding of Yorkshire Clinical Commissioning Group. The total practice population is 15996.

The proportion of the practice population in the 65 years and over age group is slightly above the England average. The practice population in the under 18 age group is the same as the England average. The practice scored five on the deprivation measurement scale. The deprivation scale goes from one to ten, with one being the most deprived. The overall practice deprivation score is higher than the England average. People living in more deprived areas tend to have a greater need for health services.

The staff team comprises seven GP partners, three female and four male. The clinical practice team includes three nurse practitioners, five practice nurses, and three health care assistants. The practice is managed and supported by a Business Manager, a Practice Manager, Office Manager, Reception Manager and a team of secretaries, administration and receptionist staff.

The practice is a teaching practice for medical students from the Hull York Medical School and a training practice for GP registrars. There are two GP registrars working at the practice.

The practice is open Monday to Friday 8am to 6pm (excluding bank holidays). Extended opening hours are provided on Monday evenings 6.30pm to 7.30pm, Wednesday mornings 7.30am to 8am and Saturday mornings 8.30am to 11.30am for booked appointments only. The practice offers appointments that can be booked in advance. Urgent appointments are available for patients that need them. The surgery is located immediately next to the out-of-hours provision for the area.

The practice provides a number of clinics, for example long-term condition management including asthma, diabetes and chronic obstructive pulmonary disease. It also offers childhood immunisations, minor surgery and travel vaccinations. It is a yellow fever centre. A clinic for over-the-counter medicines and alcohol addiction is hosted by the practice. The practice offers health checks to its patients, and also to patients who are not registered with them. The practice has a GMS contract with NHS England and it also provides some Direct Enhanced Services to its patients.

Updated 1 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on 1 March 2016. A breach of legal requirements was found. After the comprehensive inspection the practice wrote to us to say what they would do to meet the following legal requirements set out in the Health and Social Care Act (HSCA) 2008:

Regulation 19 HSCA (RA) Regulations 2014 Fit and proper persons employed Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014:

Fit and proper persons employed

How the regulation was not being met:

Recruitment arrangements did not include all necessary employment checks for all staff.

Regulation 19(3)(a) schedule 3

This inspection was a desk-based review carried out on 19 January 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 1 March 2016. This report covers our findings in relation only to those requirements.

The full comprehensive report on the Month Year inspection can be found by selecting the ‘all reports’ link for Bartholomew Medical Group on our website at www.cqc.org.uk.

Overall the practice is rated as good.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice

Updated 24 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 regular reviews of unplanned admissions

• Nationally reported data from 2014/2015 showed the percentage of patients with diabetes who had had a foot examination and risk classification in the preceding 12 months was 92%, compared with the national average of 88%.

• Longer appointments and home visits were available when needed.

• Patients with long term conditions 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.

Updated 24 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.

• Nationally reported data from 2014/2015 showed the percentage of patients with asthma on the register who had an asthma review in the preceding 12 months was 75%; this was the same as the national average.

• 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.

• Nationally reported data from 2014/2015 showed the practices uptake for the cervical screening programme was 85%, compared with the national average of 82%.

• 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 24 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.

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

• The practice held regular discussions and reviews of patients who were at risk of unplanned emergency admission to hospital.

• A pilot scheme of consultation by Skype was shortly to be set up within the care homes visited by the practice.

• The dementia assessments undertaken by a healthcare assistant, reduced onward referral rates to memory clinics by more than 50 per cent. The impact of this reduced anxiety for the patient and their family.

Updated 24 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.

• Extended hours were offered and included early mornings, late evenings and Saturday morning opening.

• 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 24 May 2016

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

• Nationally reported data from 2014/2015 showed the percentage of patients diagnosed with dementia who had had their care reviewed in a face to face meeting in the preceding 12 months was 86%, compared with the national average of 84%.

• Nationally reported data from 2014/2015 showed the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in their record was 95%, compared with the national average of 88%.

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

• The dementia assessments undertaken by a healthcare assistant, reduced onward referral rates to memory clinics by more than 50 per cent. The impact of this reduced anxiety for the patient and their family.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

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

• The practice hosted an addictions clinic for people who had problems with over-the-counter medicines and alcohol dependence.

• 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.

Updated 24 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 multi-disciplinary teams in the case management of vulnerable people.

• The practice informed 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.

• The practice offered longer appointments to patients who did not speak English as their first language. Interpreter services were available.