Barton Family Practice Also known as Dr White & Partners

Updated 1 September 2016

Barton Family Practice is registered with the Care Quality commission (CQC) as a four GP partnership. The practice is located in the village of Barton under Needwood, just outside Burton upon Trent. The area is less deprived when compared to national averages and there are a higher proportion of elderly patients when compared to local and national averages. For example, the percentage of patients aged 65 and over registered at the practice is 24% which is higher than the local Clinical Commissioning Group (CCG) average of 19% and the national average of 17%.

The practice has good transport links for patients travelling by public transport and parking facilities are available for patients travelling by car. The practice is situated on the ground floor of a two storey building owned and managed by Shaw Healthcare. There is level access to the building and all areas are easily accessible by patients with mobility difficulties, patients who use a wheelchair and families with pushchairs or prams.

The practice team consists of four GP partners (two male, two female) and a GP registrar. The clinical practice team include two nurse practitioners, a practice nurse and two healthcare assistants. Clinical staff are supported by a practice manager, an assistant practice manager and nine administration / receptionist staff. In total there are 16 staff employed either full or part time hours to meet the needs of patients. The practice is a training and teaching practice for GP trainees and medical students.

The practice is open between 8am to 6pm Monday to Friday. Appointments are from 8.10am to 12.30pm each morning, and from 1.30pm to 6pm each afternoon. The practice does not provide an out-of-hours service to its patients but has alternative arrangements for patients to be seen when the practice is closed. Patients are directed to the out-of-hours service, the NHS 111 service and the local Walk-in Centres.

The practice has a General Medical Services contract with NHS England to provide medical services to approximately 6,800 patients. It provides Directed Enhanced Services, such as the childhood immunisations, minor surgery and asthma and diabetic clinics

Updated 1 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Barton Family Practice on 4 July 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 the skills, knowledge and experience to deliver effective care and treatment.
• Feedback from patients about their care was consistently positive and the practice scored higher than local and national averages in all questions included in the GP National Patient Survey.
• 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. Investigations were made to the quality of care as a result of complaints and concerns. Results including learning outcomes were documented and shard with all staff.
• Patients complimented the practice on acess to appointments with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The practice had excellent facilities and was well equipped to treat patients and meet their needs. These included a dedicated minor surgery suite.
• There was a clear leadership structure and staff felt supported by management. There was positive comments from staff on teamwork and 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 1 September 2016

The practice is rated as good for the care of people with long-term conditions (LTCs). The GPs and nursing staff had lead roles in chronic disease management. The practice used a risk stratification tool to identify two per cent of patients most at risk of hospital admission. A care plan had been completed for each of these patients and was reviewed at least annually. The practice was a consistent high achiever for the quality outcomes framework (QOF) indicators. The latest data from 2014/15 showed that patients with long term conditions received regular reviews. For example, 99% of patients on the diabetes register had received a foot check and a risk classification in the preceding 12 months (the national average is 88%). QOF is a system intended to improve the quality of general practice and reward good practice. The practice had a robust patient recall system and used health awareness days and education events specific to an LTC to support a patient centred, empowerment approach to chronic disease.

Daily emergency appointments, longer appointments and home visits were available when needed for these patients. A structured annual review to check their health and medicines needs were being met was carried out and patients had a named GP. The practice had two dedicated chronic disease management nurses, one for asthma and chronic obstructive pulmonary disorder (COPD) and one for diabetes care. For those patients with the most complex needs, the named GP and nursing staff worked with relevant health and care professionals to deliver a multidisciplinary package of care. The practice worked with the Adult Ability Team to reduce hospital admissions and provide respite to carers.

Updated 1 September 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 who were at risk, for example, children and young people were coded after an A&E attendance so that reports could be produced to identify any patterns of regular attendance. All staff had received training in child safeguarding. Same day appointments were provided for children and were available outside of school hours. We saw positive examples of joint working with midwives and health visitors. Health visitor led baby clinics were held on the premises for child health surveillance and the practice provided postnatal checks for mother and six week baby checks. For convenience and whenever possible, the practice aimed to offer both mother and baby checks at convenient times on the same day. As part of the registration process, the practice established if a patient had parental responsibility. The practice supported mothers who wished to breastfeed their child by providing a private room and a dedicated baby changing room was available within the building. The practice worked with Changes to provide additional support to 16-25 year olds. Changes is a mental health charity that aims to promote recovery and mental wellbeing.

Updated 1 September 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 aged 65 years and over had a named GP. The practice offered home visits at designated times and urgent appointments for those older patients who had difficulty attending the surgery. The practice had high levels of older patients who lived independently. Practice staff and members of the community team we spoke with on the day described good communication spoke of a close working relationship between the practice and the healthcare staff based in the community. Detailed medication reviews were carried out on discharge from hospital and the Clinical Commissioning Group (CCG) pharmacist linked to the practice assisted in the completion of medication reviews for patients aged over 65 years. The practice achieved high uptake rates on vaccinations offered to the elderly patient cohort, for example, 100% of patients had received or declined the shingles vaccination.

Updated 1 September 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. Appointments could be booked up to two months in advance and patients told us of an effective telephone GP and nurse consultation service that provided a same day response. The practice was proactive in offering online services which included repeat prescription ordering and access to patient records. A full range of health promotion and screening that reflected the needs for this age group was also available.

Updated 1 September 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Patients diagnosed with dementia were invited for annual face to face reviews and care plans were completed. The practice regularly worked with multi-disciplinary teams in the case management of people who experienced poor mental health, including those with dementia. The practice offered patients who experienced poor mental health continuity of care and appointments with the same GP and a GP partner was the lead in managing patients with complex mental health conditions. Staff had a good understanding of how to support people with mental health needs and dementia. All staff had received training in how to deal with mental health.

Updated 1 September 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 identified as vulnerable and all reception staff had received training in safeguarding and how to deal with vulnerable patients. A register of patients with a learning disability was held and there were seven patients on the register. All were offered an annual health check with the support of the local community learning disability team, three had attended. Longer appointments were offered to patients with a learning disability. Staff were aware of their responsibilities regarding confidentiality, information sharing, documentation of safeguarding concerns and how to contact relevant agencies. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told vulnerable patients about how to access various support groups and voluntary organisations.