Benfleet Surgery

Updated 13 October 2017

Benfleet Surgery is located in a residential area of Benfleet in Essex. There are good commuter links in the town, a small car park as well as on-road parking for patients.

The patient demographics show a larger than average population aged five to 24 years old and aged 40 to 55 years old. The practice has a lower than average deprivation score compared to the CCG and national average.

The practice has a General Medical Services (GMS) contract. At the time of our inspection the practice had a patient list size of approximately 3,500. There are two partner GPs; one male and one female. The practice also employs a practice nurse, a practice manager and four receptionists.

The practice is open from 8am to 6.30pm Monday to Thursday and from 8am to 2pm on Friday. Appointments are available from 8am to 1pm on Monday to Friday and from 3pm to 6.30pm Monday to Thursday.

When the practice is closed, patients are directed to 111 for out of hours services provided by integrated Care 24.

Updated 13 October 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Benfleet Surgery on 1 June 2016 to check on improvements made following the practice being placed into special measures in September 2015. The practice was taken out of special measures and was rated as good overall. However, the practice was found to be requires improvement for providing safe services. The full comprehensive reports on the September 2015 and the June 2016 inspections can be found by selecting the ‘all reports’ link for Benfleet Surgery on our website at www.cqc.org.uk.

This announced desk based review was carried on 22 September 2017 to confirm that the practice had made the improvements required that were identified in our previous inspection on 1 June 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 safe services.

Our key findings were as follows:

• Since the previous inspection the practice had completed risk assessments in relation to the control of substances hazardous to health (COSHH). We were sent evidence of the risk assessments and safety sheets for the products in use at the practice. The practice had also completed risk assessments for other substances used at the practice. For example, liquid nitrogen and oxygen. A health and safety risk assessment had also been completed in October 2016 which was due for review in October 2017.

• Smart cards that were previously stored in the practice had since the previous inspection been removed and therefore there was no risk to patient confidentiality in relation to this.

• The governance framework was implemented and we were sent evidence of practice meetings held to show the topics discussed such as significant events, complaints and audit.

• The practice had completed second cycle audits and changes had been implemented to drive quality improvement. We saw that where improvements had been made, searches on the electronic patient record system had been planned to ensure this was ongoing.

• The practice had tried to promote a virtual patient participation group. However, there had been minimal response from the patients. The practice had focussed on their renovation project and when completed would focus on the PPG. Feedback from patients was collected on the amended complaints and comments leaflet in addition to the friends and family test and comments on NHS Choices which was monitored.

• Patients with complex needs were identified and we saw from the minutes of the practice meetings that these patients were discussed. Patients were added to the registers such as palliative and learning disabilities where appropriate. The practice had a low number of patients on the palliative care register. This was a true reflection of their patients that were appropriate for this care.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 1 September 2016

The practice is rated as requires improvement for the care of people with long-term conditions.

• GPs and the practice nurse shared the responsibility for the management of chronic diseases such as diabetes and COPD.
• Patients who had been admitted to hospital were identified and followed up.
• Data from 2014/2015 showed the practice performance for diabetes indicators was generally in line with local and national averages. For example, 40% of patients with diabetes, on the register, had a record of a foot examination and risk classification within the preceding 12 months (01/04/2014 to 31/03/2015); this was below to the CCG average of 85% and the national average of 88%. However, unverified data for 2015/2016 showed good improvements in this data.
• Longer appointments and home visits were available when needed and staff felt supported in offering these services.
• All these patients had a named GP. A programme of structured annual reviews had been commenced to check their health and medicines needs were being met.

Updated 1 September 2016

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

• GPs were able to identify 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. Staff had received appropriate levels of safeguarding training and had access to information regarding who to contact with safeguarding concerns.
• Immunisation rates for 2014/2015 were mixed when compared to local averages for standard childhood immunisations. Data for 2015/2016 showed improvements in these rates.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals. Staff had a good understanding of Gillick competency.
• The practice performance for cervical screening was comparable to local and national averages; 80% of women aged 25-64 had a record of a cervical screening test performed in the preceding five years (01/04/2014 to 31/03/2015), compared to a CCG average of 87% and a national average of 82%.
• Appointments were available outside of school hours.
• The premises were being renovated and plans included facilities for children and babies.

Updated 1 September 2016

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

• The practice had a good awareness of their older population and aimed to provide proactive, personalised care to meet their needs.
• New guidance was implemented to ensure the appropriate care and treatment of older people.
• The GPs offered home visits to older patients who were unable to attend the practice.
• Nationally reported data for 2014/2015 showed that outcomes for patients for conditions commonly found in older people were below local and national averages. However, unverified data for 2015/2016 showed considerable improvements in performance.

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 were being identified and the practice were adjusting the services it offered to ensure these were accessible, flexible and offered continuity of care.
• The practice had launched a new practice website to enable them to offer additional online services to patients.
• Appointments were available until 6.30pm Monday to Thursday to assist working age people access appointments.

Updated 1 September 2016

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

• Data from 2014/2015 showed 9% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in their record, in the preceding 12 months (01/04/2014 to 31/03/2015); this was below the CCG average of 77% and the national average of 88%. However, unverified data from 2015/2016 showed a considerable improvement in performance.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations and information was available on their new website.
• Staff had an understanding of how to support patients with mental health needs and dementia.

Updated 1 September 2016

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

• The practice had recently compiled a register of patients living in vulnerable circumstances including those with a learning disability.
• There was a policy for registering patients with no fixed address and we saw evidence of these patients being cared for.
• The practice offered longer appointments for patients who needed them.
• The practice informed vulnerable patients about how to access support groups.
• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were all trained to a suitable level in safeguarding 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.
• The practice had identified patients who were carers and signposted these patients to support groups and offered them additional support.