Bell House Medical Centre

Updated 12 July 2016

Bell House Medical Centre is a GP practice which provides primary medical services under a General Medical Services (GMS) contract to a population of approximately 9,600 patients living in Luton town centre and the surrounding areas. A GMS contract is a nationally agreed contract used for providing medical services.

The practice operates from a two storey building built in the 1930s. Access for patients with mobility difficulties or patients with young children using pushchairs could be gained from the rear of the building where a ramp had been made available. Consultations take place on both floors and the practice make arrangements for patients with mobility difficulties to be seen on the ground floor.

The practice population has a higher than average number of patients aged 0 to 10 years and 20 to 35 years and higher older population aged over 75 years. National data indicates that the area is one that experiences higher than average levels of deprivation. The practice population is diverse and made up of white British and patients of differing Asian ethnic origins, with a specific increase in Pakistani patients in recent years.

There are five GP partners; two female and three male GPs. The practice employ one practice nurse and two health care assistants (HCA), a practice manager and deputy manager who are supported by a team of administrative and reception staff. The practice is a training practice which supports doctors who are carrying out training to be a GP.

The practice is open from 8.00am to 12.30pm and 1.15 to 6.00pm Monday to Friday. They provide extended hours appointments once a week until 9pm on alternate Mondays and Thursdays for pre booked appointments.

When the surgery is closed services are provided by Care UK  out of hours provider who can be contacted via NHS 111. During core practice hours when the practice is closed, for example, 6pm until 6.30pm and during lunch times, the duty GP covers for patients contacting the practice.

Updated 12 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bell House Medical Centre on April 2014. 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 and all staff were aware and involved in issues relating to patient safety.

• 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.
• Generally patients said they found it easy to make an appointment although some patients reported having to wait longer if they wished to see a named GP. Patients told us they could always see a GP if they needed to with urgent appointments available the same day.
• The practice had adequate facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management and demonstrated evidence of a cohesive team. 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.

There were areas where the practice should make improvements:

• The practice should ensure that information regarding how to complain is provided in the waiting area.
• Continue to carry out regular fire drills
• Continue to identify and support carers
• Review the practice business continuity plan routinely to ensure information remains up to date

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 12 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 had systems in place to address patients who did not attend for medication review and suffered with a long term condition.
• 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 care professionals to deliver a multidisciplinary package of care.
• The practice carried out audits to ensure best practice was provided to patients with long term conditions.
• The practice had access to an Asian dietician and language specific education programmes for patients with diabetes.
• The practice offered ‘one stop’ appointments for patients with more than one long term condition to prevent the need for several visits to the practice.

Updated 12 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 considered at risk, for example, children and young people who had a high number of A&E attendances. Immunisation rates were 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.
• Cervical screening rates were 76% which were comparable with the national average of 74%.
• Appointments were available outside of school hours and whilst the front entrance to the practice was not easy for pushchair or mobility aid access, the practice had made provision for access via the back of the building.
• We saw positive examples of joint working with midwives and health visitors.
• Chlamydia screening was also offered to young people aged from 15 to 24 years.
• The practice had access to a mental health crisis team specifically for patients aged 16 to 35 years.

Updated 12 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 and all patients had a named GP.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs and held a list of patients who were housebound.
• Older patients at risk of admission to hospital, who were vulnerable or on the palliative care register were discussed at monthly multi-disciplinary meetings to ensure an holistic approach to care.
• The practice had reminders on the computer system to alert staff to older patients who required a health or medicine review.

Updated 12 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.
• Post-natal checks were available which included depression screening and family planning advice and eight week baby checks were provided prior to immunisation.
• Patients who had suffered gestational diabetes were screened yearly for diabetes.

Updated 12 July 2016

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

• 85% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the national average of 84%.
• 93% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in their record, in the preceding 12 months compared with the national average of 88%
• 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.
• All new patients who were newly diagnosed with dementia were referred to the psycho-geriatrician.
• The practice had access to the mental health crisis team.
• 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 12 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 those with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• The practice had recently employed two staff who could speak Bengali and Urdu to help patients whose first language was not English as there had been a significant increase in patients of this ethnic origin.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• Information regarding about how to access various support groups and voluntary organisations was provided for vulnerable patients, for example the community drugs and alcohol service.
• 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.