Burnham Health Centre

Updated 9 August 2016

The Burnham Health Centre is situated in Burnham. The practice is a purpose built premises with car parking for patients and staff. There is ramp access for patients and visitors who have difficulty managing steps. All patient services are on the ground floor. The practice comprises of 14 consulting rooms, eight treatment rooms, three patient waiting areas, administrative and management offices and meeting rooms.

There are nine GP partners, two salaried GPs, two short term locum GPs and three trainee doctors at the practice. Six GPs are female and 10 male. The practice employs two senior practice nurses, six practice nurses and four health care assistants. The practice manager is supported by practice administration manager, deputy administration manager, two senior receptionists and a team of administrative and reception staff. Services are provided via a General Medical Services (GMS) contract (GMS contracts are negotiated nationally between GP representatives and the NHS).

When we inspected the practice in November 2015 we found two partners were not added on CQC registration certificate.

At the inspection on 21 July 2016, we found that the practice had responded positively to the previous CQC inspection report and the practice CQC registration certificate was in compliance. We noted that the ratings poster of previous CQC inspection was not displayed in the premises. The practice manager informed us they had displayed the ratings poster on the notice board near entrance but was not aware someone had removed it. However, the practice had displayed framed ratings poster within 48 hours after the inspection at four various locations in the premises. We noted that the previous CQC inspection report was shared on the practice’s website.

The practice has a patient population of approximately 22,000 registered patients. The practice population of patients aged between 35 and 54 years is higher than national and Clinical Commissioning Group averages and there are a lower number of patients between 15 and 29 years old.

Services are provided from following location:

Burnham Health Centre

Minniecroft Road

Burnham

SL1 7DE

The practice has opted out of providing out of hours services to their patients. There are arrangements in place for services to be provided when the surgery is closed and these are displayed at the practice, in the practice information leaflet and on the patient website. Out of hours services are provided during protected learning time and 30 minutes after closing time (between 6pm and 6:30pm) by East Berkshire Primary Care service or after 6:30pm, weekends and bank holidays by calling NHS 111.

Updated 9 August 2016

Letter from the Chief Inspector of General Practice

Our previous comprehensive inspection in November 2015 found breaches of regulations relating to the safe, effective and responsive delivery of services.

We found Burnham Health Centre required improvement for the provision of safe, effective and responsive services. The practice was rated good for providing caring and well-led services. Consequently we rated all population groups as requiring improvement.

This inspection in July 2016 was undertaken to check the practice was meeting regulations that were in breach from the last inspection. For this reason we have only rated the location for the key questions to which these relate. This report should be read in conjunction with the full inspection report of 5 November 2015.

We found the practice had made improvements since our last inspection. At our inspection on the 21 July 2016 we found the practice was meeting the regulations that had previously been breached.

Specifically we found:

• The practice had reviewed their recruitment policy and developed a comprehensive recruitment checklist and demonstrated appropriate recruitment checks had been undertaken prior to employment.
• All clinical and non-clinical staff had received an appraisal within the last 12 months and all staff had received training relevant to their role.
• The practice had taken number of steps to improve the appointments booking system and access to a named GP.
• The practice had increased the number of online appointments and there was a dedicated member of staff who was monitoring appointment booking system. This included the duration it takes to answer the telephone calls.
• Some patients we spoke with on the day and comment cards we received were in line with national GP survey results (based on 105 results which represented 0.50% of the practice’s patient list size) findings that patients had to wait a long time to get through to the practice by telephone during peak hours in the morning.
• However, the practice had carried out an internal survey in July 2016, which was completed by 1,010 patients. This represented 4.60% of the practice’s patient list. Results from the internal survey showed improved results and most of the patients were satisfied with their access to care and treatment.
• We saw that the practice CQC registration certificate was up to date.
• On the day of inspection, we noted that the ratings poster of previous CQC inspection was not displayed in the premises. The practice manager informed us they had displayed the ratings poster on the notice board near entrance but was not aware someone had removed it. However, the practice had displayed framed ratings poster within 48 hours after the inspection at four various locations in the premises.
• We noted that the previous CQC inspection report was shared on the practice’s website.

We have amended the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe, effective, caring, responsive and well led services. Consequently we have rated all population groups as good.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 9 August 2016

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

• There were clinical leads for chronic disease management and patients at risk of hospital admission were identified as a priority.
• The practice was providing diabetic eye screening, breath well clinics, physiotherapy, ultrasound and wound care clinics at the premises.
• Longer appointments and home visits were available when needed.
• All patients with long term conditions had a named GP and a structured annual review to check that 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 9 August 2016

The practice is rated as good for the care of families, children and young patients.

• 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 patients 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 patients were treated in an age-appropriate way and were recognised as individuals.
• The practice’s uptake for the cervical screening programme was 81%, which was higher than the national average of 77%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw good examples of joint working with midwives, health visitors and school nurses.
• The practice was providing youth counselling and sexual health clinics.

Updated 9 August 2016

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

• The practice offered proactive, personalised care to meet the needs of the older patients in its population.
• It was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• The percentage of patients aged 65 or over who received a seasonal flu vaccination was lower (70%) than the national average (73%).
• The premises were accessible to those with limited mobility.
• There was a register to manage end of life care and unplanned admissions.
• There were good working relationships with external services such as district nurses.
• The practice offered chiropodist (toe nail clipping) services through external organisation.
• The practice was working closely with Burnham Health Promotion Trust and encouraging older patients to take part in community activities.

Updated 9 August 2016

The practice is rated as good for the care of working-age patients (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. For example, the practice was offering early morning walk-in appointments at 7.45am for working-age patients.
• 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.
• Extended hours appointments were available two mornings from 7am to 8am and one evening from 6pm to 8.30pm during weekdays. The practice also offered additional extended appointments one Saturday every month from 7.45am to 11.45am.

Updated 9 August 2016

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

• 73% of patients experiencing poor mental health were involved in developing their care plan in last 12 months.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice had told patients experiencing poor mental health how to access various support groups and voluntary organisations.
• Systems were in place to follow up patients who had attended accident and emergency, when experiencing mental health difficulties.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 9 August 2016

The practice is rated as good for the care of patients 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.
• It offered annual health checks for patients with learning disabilities. Health checks were completed for 11 patients out of 46 patients on the learning disability register. However, the practice GPs were regularly visiting care homes and promoting health passports for patients with learning disability.
• Longer appointments were offered to patients with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients.
• It had told 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 was providing a drop-in service for patients with drug and alcohol problems.