Dr Baker & Partners Practice Also known as St Georges Medical Practice

Updated 23 June 2017

Dr Baker and Partners is located within purpose built premises which has been extended several times. The building is also shared with another practice. The practice is located in a residential area of Benfleet, Essex which has good public transport links. There is limited parking available for patients at the practice. The practice profile shows there is a larger than average population aged 60 years and over, and a smaller than average population aged 45 years and under.

At the time of our inspection the practice had a list size of 6349 patients. There are four GP partners, two male and two female. The nursing team consisted of two advance nurse practitioners, three practice nurses, one health care assistant and an associate practitioner. The nursing team also worked for the other practice within the same building.

There is also a joint practice management and non-clinical team who serve the two practices. This team includes two practice managers, an assistant practice manager, a reception manager and a number of administrative and reception staff.

The practice is a training practice for nurses and has recently been approved as a training practice for GP trainees. The practice had one GP trainee the time of our inspection.

The practice is open between 8am and 7pm on weekdays. Appointments are available between 8.30am and 12pm and again between 3.30pm and 6pm on weekdays. The practice is a member of the local GP Alliance which provides appointments to patients at two locations at weekends.

When the practice is closed, patients are directed to call 111 to access out of hour’s services provided by Integrated Care 24.

Updated 23 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Baker & Partners Practice on 18 May 2016 where the practice was rated as good overall. However the practice was found to be requires improvement for providing effective services. The full comprehensive report on the May 2016 inspections can be found by selecting the ‘all reports’ link for Dr Baker & Partners Practice on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 9 June 2017 to confirm that the practice had carried out their plan to make the improvements required identified in our previous inspection on 18 May 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

The practice is rated as good for providing effective services.

Our key findings were as follows:

• The practice had completed audits and had planned to conduct one audit per year to drive improvement in patient outcomes.
• The practice had implemented searches to assist in proactively identify patients in need of palliative care and provide them with appropriate care and treatment.
• The practice had a matrix for training in place and was looking at different ways to identify training needs.
• At the previous inspection the practice had identified 0.5% of their patients as carers; this had not increased at this review. The practice had ways to support carers in place.

Actions the practice SHOULD take to improve:

• Review process and methods for identification of carers and the system for recording this to enable support and advice to be offered to those that require it.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 16 June 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.
• National data for people with long-term conditions, such as diabetes, was comparable to local and national averages. For example, 80% of patients with diabetes, on the register, had their last IFCCHbA1c recorded as 64 mmol/mol or less in the preceding 12 months (01/04/2014 to 31/03/2015); this was comparable to the CCG average of 75% and the national average of 78%.
• Longer appointments and home visits were provided when needed.
• The practice promoted educational courses for patients with long-term conditions to enhance self-care.
• 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.

Updated 16 June 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.
• Immunisations were provided by the nursing team. The rates were comparable to CCG averages 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. Staff had a good understanding of Gillick competency.
• The cervical screening rate was above average; 89% of women aged 25 to 64 years old had a record of a cervical screening test having been performed in the preceding 5 years (01/04/2014 to 31/03/2015), this was above the CCG average of 87% and the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice maintained close links with midwives and health visitors and actively managed six week post-natal checks.
• The practice actively engaged with local schools to promote topics such as hand washing.

Updated 16 June 2016

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

• The practice offered proactive, personalised care, in line with clinical guidelines, to meet the needs of the older people in its population.
• The practice worked with other organisations such as dementia services and a local falls clinic to identify health concerns in older people.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• Patients living in care homes were visited when required.
• National data for patient outcomes for conditions commonly found in older people, such as COPD, was comparable to local and national averages.

Updated 16 June 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 signed up to the local GP Alliance to offer patients weekend appointments at an alternative location.
• The practice was proactive in offering online services and were implementing a system to provide Skype consultations with a GP. Text messaging and emails were also used to enhance communication.
• There was a full range of health promotion and screening that reflected the needs for this age group.
• Health checks were promoted for patients aged 40 to 74 years old.

Updated 16 June 2016

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

• 96% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months; this was above to the CCG average of 80% and the national average of 84%.
• National data for other mental health indicators showed the practice performance was comparable to local and national data.
• The practice regularly worked with multi-disciplinary teams and local services 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.
• In-house counselling, provided by the CCG, was available to patients.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations including a befriending service and some volunteering opportunities.
• 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 16 June 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. There was a system in place to register patients with no fixed abode.
• The practice offered longer, flexible appointments for patients with a learning disability. Home visits were also available for this patient group to offer health checks and on-going care as required.
• The practice regularly worked with other health care professionals and external organisations in the case management of vulnerable patients.
• The practice informed vulnerable patients and their families about how to access various support groups and voluntary organisations.
• Staff had a good understanding of how to recognise signs of abuse in vulnerable adults and children and how to act on these concerns. Staff were trained and 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.