Great Barford Surgery

Updated 19 July 2016

The practice is located in a purpose built health centre, in Silver Street, Great Barford, Bedfordshire. Based on data available from Public Health England, the area served is within the top 10% least deprived areas nationally. The practice population has higher than the national average aged between 45-75 years and lower than the national average between the ages of 0-9 years and 20-39 years. The practice has a registered list size of approximately 4,753 patients. The practice holds a general medical services contract (GMS) for providing services, a nationally agreed contract.

The Dispensary at the surgery dispenses medicinesforthose patientsthat live more than one mile from a chemist and who are registered on the practice dispensing list.

The Practice staff includes two male GP partners and a female salaried GP, two practice nurses, one health care assistant and four staff who support the dispensary. The team is supported by the practice manager and eight administrative staff, including medical secretaries and receptionists.

The practice is open from between 8.30am and 1pm and from 2pm to 6pm, Monday to Friday. Patients can contact the practice from 8am. Appointments are available between 8.00am and 1pm and between 2pm and 6pm Monday to Friday.

When the practice is closed, out of hours services are provided by Bedfordshire Doctors On Call (BEDDOC) for patients who require the services of GP.

The practice was inspected by CQC on 30 July 2013.

Updated 19 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Great Barford Surgery on 8 March 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.

The area where the provider should make improvement is:

• Continue to work to improve patient satisfaction scores.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 July 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 performance relating to diabetes indicators was comparable to the CCG and national averages, for example, The percentage of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months was 89% compared to the CCG average of 90% and the national average of 88%.

• 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.

• Medicine review dates were noted in the patient record and printed on the repeat medicine request slips.

Updated 19 July 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 slightly higher than local and national averaged for all standard childhood immunisations.

• The practice offered specific times for immunisation clinic appointments for parents who experienced needle phobia.

• 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 84%, which was comparable to the CCG average of 83% and above the national average of 74%.

• 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, and health visitors.

Updated 19 July 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 arranged for a hearing advisor to attend each month to advise patients with difficulties in the practical elements of their hearing aids. Replacement batteries were available from the reception.

• Appoximately 50% of the practice list,in this group used the online system for booking appointments and prescription requests.

• Flu vaccination clinics were held in the local community hall which offered better parking facilities for patients than the practice could offer. The majority of patients using this venue were older people.

• The dispensary team and GPs offer blister packs to aid medicines management.

Updated 19 July 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.

• NHS health check invitations sent to all those not in receipt of regular monitoring for other conditions.

• The practice offered a variety of appointments, same day and bookable in advance along with telephone consultations.

• The practice used the electronic prescription service.

• Temporary registration status was offered for university students returning home during breaks and holiday times.

• For this group the practice also offered immunisation catch up programs in line with local guidance and schemes, appointments offered outside of term time, half term flu vaccination clinics and sexual health advice.

Updated 19 July 2016

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

• The practice had lower than average results for this group for example, 67% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, lower than the CCG and national averages of 84%. The practice was aware of this and was monitoring the number of consultations and reviews to improve the results.

• 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 self-referral process into the improving psychological therapies service.

• 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.

• Staff had undertaken dementia awareness training.

Updated 19 July 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.

• 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.

• Staff had received safeguarding training appropriate to their role.

• The practice offered seven day prescriptions to those who required it.

• Vulnerable patients were encouraged to nominate a friend or relative, to be registered on the system to communicate on their behalf.