Close Farm Surgery

Updated 5 May 2016

Close Farm Surgery, 47 Victoria Road, Warmley, Bristol, BS30 5JZ. The practice provides support for approximately 7090 patients in a central residential area of Warmley and the surrounding areas of North Common, Oldland Common, Bitton, Longwell Green, Wick and Kingswood. There is a small dispensary in the practice for patients who do not have local access to a pharmacy.

The building is accessible to patients with restricted mobility, wheelchair users and those using pushchairs,all consulting and treatment rooms are on the ground floor. There are administrative offices, meeting and staff rooms on the first floor. There are disabled car parking spaces at the front of the building. There are a small number of parking spaces to the side of the practice or alternatively patients can park nearby.

There are three partners and three salaried GPs. Two male and four female GPs. There are two Practice Nurses and two Health Care Assistants. The clinical staff are supported by a practice business manager and an administration team.

The practice’s core opening hours are from 8am to 6.30pm, Monday to Friday. There are extended hours surgeries with their clinical team either Monday or Tuesday evenings until 7:45pm. GP surgeries are usually from 8:30 am to 11:30am and again 3:30/4pm to 6:30pm. The practice nurses hold regular clinics from 8:30 until 12:30 and again 4pm until 6:30pm each day. There is a variety of other clinics such as under five year old immunisations and baby clinics held once a week. All surgery consultations are by appointments which can be made via the telephone during office hours or by using the practices website.

The practice has a Personal Medical Services contract with NHS England. The practice is contracted for a number of enhanced services including the practice is authorised to dispense medicines, facilitating timely diagnosis and support for patients with dementia, and childhood vaccination and immunisation scheme. The practice was a teaching practice for medical students.

The practice does not provide Out Of Hour’s services to its patients, this is provided by BrisDoc. Contact information for this service is available in the practice and on the website.

Patient Age Distribution(2015)

0-4 years old: 5.1% (similar to the national average of 5.9%)

5-14 years old: 10.1% (similar to the national average of 11.1%)

The practice had identified that of their population they serve:

30-39 years old: 12.3%

40-49 years old;12.6%

50-59 years old:17.1%

The practice had 6.4% of the practice population aged 75 years and above (the national average 7.8%)

The practiced had 52.7%(2014-2015) of patients with a long standing health condition, below the Clinical Commissioning Group(CCG) average of 54.1% and national average of 54%.

Other Population Demographics

% of Patients in paid work or full time education: 72.9 % (the national average 61.5%)

Practice List Demographics / Deprivation

Index of Multiple Deprivation 2015 (IMD): 10.7 (below the national average 21.8)

Income Deprivation Affecting Children (IDACI): 12.7% (below the national average 19.9%)

Income Deprivation Affecting Older People (IDAOPI): 10.6% (above the national average 16.2%)

Updated 5 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Close Farm Surgery on 3 March 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 5 May 2016

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

• Performance for diabetes related indicators was better or similar to the national average. The percentage of patients on the diabetes register, with a record of a good examination and risk classification within the preceding 12 months (01/04/2014 to 31/03/2015) was 94.9%, the national average was 88%.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.

Updated 5 May 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 people who had a high number of A&E attendances. Immunisation rates were relatively high 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.

• The practice’s uptake for the cervical screening programme was 85.1%, which was better than the Clinical Commissioning Group average of 78.5% and the national average of 81%.

• 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.

Updated 5 May 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.

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

• The practice was a dispensing practice for some of its patients and had made some reasonable adjustments for patients who struggled to manage their own medicines, for example, by the provision of Dosette boxes; included in the Dosette boxes also a large print version of repeat prescription form if it was required.

• They provided a delivery service to a secure location where patients could collect their medicines.

Updated 5 May 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.

• 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.

Updated 5 May 2016

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

• Performance for mental health related indicators was better or similar to the national average. For example, the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan documented in their records, in the preceding 12 months (01/04/2014 to 31/03/2015) was 100%; the national average was 88.4%. The practice regularly worked with multi-disciplinary teams 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.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• 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 5 May 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, and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• The practice informed 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.