Briarwood Medical Centre

Updated 26 January 2017

Briarwood Medical Centre is a member of the NHS Greater Preston Clinical Commissioning Group (CCG). Personal Medical Services (PMS) are provided under a contract with NHS England.

The surgery is based in a converted building over two floors. There are consulting rooms on the ground and first floors. Patients with limited mobility access facilities on the ground floor. The practice has recently put in a bid for a service lift to the first floor, to improve access overall. There is a car park at the front of the building and a disabled ramp to the front door.

The practice is located in an area of medium deprivation in Ashton on the outskirts of Preston Lancashire. Information published by Public Health England rates the level of deprivation within the practice population group as six on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

The practice currently has a patient list size of 5,808. The average life expectancy of the practice population is comparable with both CCG and national averages for males at 78 years (compared to CCG 77 years and national average 79 years). Life expectancy for females is also comparable with CCG and national averages at 81 years (CCG 81 years and national average 83 years). Age groups and population groups within the practice population are comparable with CCG and national averages.

There are three GPs (one female and two male) at the practice. Nursing staff consist of a one advanced nurse practioner (ANP) and two practice nurses; all of whom are female. There is a practice manager, and a team of reception and administrative staff who oversee the day to day running of the practice.

Briarwood is a teaching and training practice. They are accredited to train doctors to become GPs (registrars) and to support undergraduate medical students with clinical practice and theory teaching sessions. They have recently received a gold award for their teaching provision at the practice awarded by the University of Manchester.

The practice has good working relationships with local health and social services to support provision of care for its patients. They have close working links with care and nursing homes. Regular visits are made by the clinicians to these sites.

The practice is open Monday to Friday 8am to 6.30pm with extended hours on a Sunday from 9am-12noon.

In addition to pre-bookable appointments that could be booked up to four weeks in advance, the practice has daily urgent appointments triaged by the ANP.

When the practice is closed out of hours services are provided by Preston primary care by telephoning NHS 111.

Updated 26 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Briarwood Medical Centre on 22 November 2016. Overall the practice is rated as good for providing safe, effective, caring, responsive and well-led care for all of the population groups it serves.

Our key findings across all the areas we inspected were as follows:

• The practice staff had a very good understanding of the needs of their practice population and were flexible in their service delivery to meet patient demands; such as providing flexible GP appointments when required.
• There was a clear leadership structure, staff were aware of their roles and responsibilities and told us the GPs were accessible and supportive.
• There was evidence of an all-inclusive team approach to providing services and care for patients.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• There was good access to clinicians and patients said they generally found it easy to make an appointment. There was continuity of care and if urgent care was needed patients were seen on the same day as requested.
• Patients’ needs were assessed and care was planned and delivered following local and national care pathways and National Institute for Health and Care Excellence (NICE) guidance.
• The practice promoted a culture of openness and honesty. There was a nominated lead for dealing with complaints and significant events. All staff were encouraged and supported to record any incidents using the electronic reporting system. There was evidence of good investigation, learning and sharing mechanisms in place.
• Risks to patients were assessed and well managed.
• There was a safeguarding lead in place and comprehensive systems to protect patients and staff from abuse.
• The practice sought patient views of how improvements could be made to the service, through the use of patient surveys, engagement with the (Patient Representative Group) PRG and the NHS Friends and Family Test.
• Staff said they were proud to work at the practice and felt they delivered a good quality service to patients.
• The practice complied with the requirements of the duty of candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment.)

However there were areas of practice where the provider should make improvements:

• The practice should review how it can best protect confidentiality for patients in the reception area.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 26 January 2017

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

• The practice nurses had lead roles in the management of long term conditions, supported by the GPs. Annual reviews were undertaken to check patients’ health care and treatment needs were being met.

• The practice maintained a register of patients who were a high risk of an unplanned hospital admission. Care plans and support were in place for these patients.

• 63% of diabetes had measured total cholesterol in the last 12 months compared to 68% locally and 70% nationally.

• 76% of patients diagnosed with chronic obstructive pulmonary disease (COPD) had received a review in the last 12 months, in line with 77% locally and 89% nationally.

Updated 26 January 2017

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

• The practice worked with midwives, health visitors to support the needs of this population group. For example, the provision of ante-natal, post-natal and child health surveillance clinics.

• 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.

• Patients and staff told us children and young people were treated in an age-appropriate way and were recognised as individuals.

• Appointments were available outside of school hours and the premises were suitable for children and babies. Same day access was available for all children under the age of five.

• Sexual health, contraceptive and cervical screening services were provided at the practice.

• 82% of eligible patients had a cervical screening test in the preceding 5 years, compared to 74% locally and 76% nationally.

Updated 26 January 2017

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

• Proactive, responsive care was provided to meet the needs of the older people in its population.

• The advanced nurse practioner (ANP) co-ordinated care for patients aged over 75.

• Registers of patients who were aged 75 and above and also the frail elderly were in place to ensure timely care and support was provided. Health checks were offered for all these patients.

• The practice worked closely with other health and social care professionals, via multi-disciplinary care teams. This helped housebound patients receive co-ordinated care and support and reduced hospital admissions.

• The ANP had dedicated time weekly to work in the community with local care home patients.

Updated 26 January 2017

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

• The needs of these patients 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 provided telephone and email consultations, online booking of appointments and ordering of prescriptions.
• Sunday appointments were offered to increase flexibility for working patients.
• The practice offered a range of health promotion and screening that reflected the needs for this age group.
• Health checks were offered to patients aged between 40 and 74 who did not have a pre-existing condition.
• Travel health advice and vaccinations were available.

Updated 26 January 2017

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

• Patients and/or their carer were given information on how to access various support groups and voluntary organisations.
• 78% of patients diagnosed with dementia had received a face to face review of their care in the last 12 months, compared to 81%  locally and 78% nationally.

• The practice had developed comprehensive care plans for patients with dementia.

• Same day appointments / phone consultation were made for patients experiencing poor mental health.

Updated 26 January 2017

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

• Staff knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.

• We saw there was information available on how patients could access various local support groups and voluntary organisations.

• Annual reviews for patients with a learning disability were provided where the patient preferred for example at their home or at the practice. The ANP was the named nurse who supported delivery of annual reviews of their care.