Birchwood Medical Practice

Updated 17 March 2016

Birchwood Medical Practice is a GP practice which provides a range of primary medical services to around 9,600 patients from a surgery in Birchwood, a suburb on the outskirts of the city of Lincoln. The practice’s services are commissioned by Lincolnshire West Clinical Commissioning Group (LWCCG).

The service is provided by two male GP partners and three female partners who between them provide 37 sessions per week. There is also a nursing team comprising a senior nurse, four part time practice nurses and one full time healthcare assistant. They are supported by a practice manager, a deputy practice manager and a team of reception and administration staff. Birchwood Medical Practice is a training practice and at the time of our inspection there were three GP trainees and a foundation (FY2) doctor.

The practice has a General Medical Services Contract (PMS). The GMS contract is the contract between general practices and their commissioner for delivering primary care services to local communities.

Local community health teams support the GPs in provision of maternity and health visitor services.

The practice has one location registered with the Care Quality Commission (CQC). The location we inspected was Birchwood Medical Practice, Birchwood Health Centre, Jasmin Road, Birchwood, Lincoln road, , LN6 0QQ.

The surgery is a single storey purpose built premises with car parking which includes car parking spaces designated for use by people with a disability.

We reviewed information from Lincolnshire West CCG and Public Health England which showed that the practice population had deprivation levels in line with the average for practices in England.

The practice is open between 8.00am and 6.30pm Monday to Friday. Extended surgery hours are offered on Mondays from 1830 to 8.00pm with prebookable GP and nurse appointments available and on Wednesdays from 7.00am to 8.00am when appointments are available with a GP or healthcare assistant (HCA). The practice is open between 0800 and 1830 Monday to Friday.

The practice has opted out of the requirement to provide GP consultations when the surgery is closed. The out-of-hours service is provided by Lincolnshire Community Health Services NHS Trust.

Updated 17 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Birchwood Medical Practice on 3 February 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.
• 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.
• 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 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 17 March 2016

The practice is rated as good for the care of people with long term conditions.

• Nursing staff were well qualified in chronic disease management and there was a lead for each chronic disease.

• 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.

• Effective recall procedures in place for disease monitoring with annual (on birthday) reviews and electronic prescribing and online ordering.

• Practice nurses available during extended hours to facilitate ease of access for chronic disease reviews

• Management of leg ulcers and dressings

• Year round immunisation services with additional clinics during flu season

• All day in-house and domiciliary phlebotomy service

Updated 17 March 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.

• 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.

• Twice weekly midwife clinic

• Daily 'open' children’s’ GP surgery

• Sexual health & contraception clinic including chlamydia screening, IUD, IUS, implant, C-Card scheme

• Toy tables in each consulting/treatment room and waiting room.

Updated 17 March 2016

The practice is rated as good for the care of older people.

• Care plans were in place and updated through monthly multi-disciplinary meetings with District Nurses for patients on the ‘at risk’ and palliative care register. Urgent telephone access was available to the named GP.

  The practice worked other agencies such as Macmillan and Complex Care nurses, the local Neighbourhood Team, the Primary Care Navigator, and the Independent Living Team to create individualised care plans that respected patient’s wishes.

• .Weekly visits undertaken and urgent telephone access to Care Homes by their responsible GP.

• A leg ulcer service

• Practice Nurse & HCA home visits by a practice nurse or HCA were available.

Dementia Friendly through training.

Updated 17 March 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• Out of Area registrations

• Same day urgent triage

• Telephone consultations

• In house phlebotomy service

• Extended hours – early morning & evening appointments with GP, nurse or HCA

• Men's Health Appointments

• NHS health checks

• In house physiotherapy & podiatry service

• Travel clinic - advice and vaccination

• Nurses trained in smoking cessation

• Referral to weight watchers and exercise referrals

• Minor surgery facilities

Updated 17 March 2016

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

• Mental health care plans and annual reviews

• Contact with Mental Health Liaison Nurse

• Regular contact with Community Psychiatric Nurse

• In house memory clinic

• Signposting and referral to appropriate support agencies

• Same day urgent triage

• Opportunistic dementia screening for at risk patients

• Dementia aware and Dementia Friendly staff

• Carer support & signposting

Updated 17 March 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice list was open to all patients including the homeless.

• There was a learning disability lead within the practice and annual health checks for patients with learning disability. Flexible appointments were available for this group of patients.

• The practice regularly worked with multi-disciplinary teams such as health visitor, social services and the neighbourhood team in the case management of vulnerable people.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations such as food banks and citizens advice bureau.

• Staff gave examples which illustrated they 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.

• Translation services were available which included on the check in screen and practice website.