The Family Practice

Updated 10 August 2016

The Family Practice is located in a residential area of the city of Bristol. They have approximately 14,282 patients registered.

The practice operates from one location:

Western College

Cotham Road

Bristol

BS6 6DF

The Family Practice is situated in a Grade II listed building in a residential area of the City of Bristol. It serves patients from the Cotham, Kingsdown and Clifton areas of Bristol. The building was originally a theological college in 1903 and has many unique architectural features and has been used as a GP practice since 1993. The main patient areas of the practice are situated on the ground floor of the building with seven consulting rooms and a large treatment room with five patient areas. There is an additional consulting room, offices and meeting rooms on the first floor. There is no lift to the first floor. There is parking for approximately 30 vehicles at the side of the practice.

The practice is made up of seven GP partners and two associate GPs. Four female and five male. They have one nurse practitioner, three practice nurses and three healthcare assistants. They are supported by a practice business manager, reception and administration team. The practice is a training practice for GPs and a teaching practice for medical students.

The practice opening hours are from 8.15am until 6.30pm, Monday, Tuesdays, Thursdays and Fridays. Wednesday the practice opens at 8.15am and closes for staff training at 12 and reopens at 2pm until 6.30pm. The practice is open one evening per week from 6:30pm to 8pm for routine GP and nurse appointments and alternate Saturday mornings 8:30am to 11:45pm for GP appointments only.

The practice has a Personal Medical Services contract with NHS England. The practice is contracted for a number of enhanced services including extended hours access, improving patient’s online access, supporting patients with a learning disability and unplanned admission avoidance.

The practice does not provide out of hour’s services to its patients, this is provided by the 111 services and BrisDoc. Contact information for this service is available in the practice and on the practice website.

Patient Age Distribution

0-4 years old: 4.7% (the national average 5.9%)

5-14 years old: 9.1% (the national average 11.4%)

Total under 18 years old: 16% (the national average 20.7%)

65+ years old: 12.3% (the national average 17.1%)

75+ years old: 4.9% (the national average 7.8%)

85+ years old: 1.6% (the national average 2.3%)

Other Population Demographics

% of Patients with a long standing health condition is 46.2% (the national average 54%)

% of Patients in paid work or full time education is 72.1% (the national average 61.5%)

Practice List Demographics / Deprivation

Index of Multiple Deprivation 2015 (IMD): is 13% (the national average 21.8%)

Income Deprivation Affecting Children (IDACI): is 7.8% (the national average 19.9%)

Income Deprivation Affecting Older People (IDAOPI): is 14.5% (the national average 16.2%)

Patient Gender Distribution

Male 48.7%

Female 51.3%

% of patients from BME populations 8.57%

Patient turnover 2015 14.1%, the national average 8.5%.

Updated 10 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Family Practice on 11 May 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 been trained to provide them with 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and 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.
• The percentage of respondents to the GP patient survey who described the overall experience of their GP surgery as fairly good or very good was 95% compared to the clinical commissioning group of 86% and national average of 85%. Also 92% of patients said they would recommend this GP practice to someone who has just moved to the local area compared to the CCG average of 81% and the national average of 80%.

The areas where the provider should make improvement are:

• The practice should review current good practice guidelines to ensure that clinical staff are trained to the appropriate level for their role for safeguarding children

• The practice should provide formal training for staff who carry out the chaperone role.

• The practice should review elements of the environment relating to risks to infection control management such as the wooden panelling and facilities, including floor surfaces in some consulting rooms.

• The practice should review how fire safety is managed so that fire risk assessments, fire drills, emergency lighting and safety checks are carried out in accordance to best practice and sustained.

• The practice should implement an effective system to identify carers in order to provide the most appropriate care for them.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 August 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.

• 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 10 August 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. 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.

• 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 10 August 2016

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

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

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

Updated 10 August 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 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 10 August 2016

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

• 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 was participating in a pilot with a mental health nurse available in the practice on a daily basis.

• 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 10 August 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 homeless people, travellers and those with a learning disability.

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

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• 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.