Redgate Medical Centre

Updated 20 May 2016

The practice is located on the east side of Bridgwater, a town located close to the M5 motorway eight miles south west of Taunton, on the edge of the Somerset Levels in the Sedgemoor district of the county of Somerset. The practice provides primary medical services for approximately 6,500 patients within the town.

The practice is located in a purpose built building (built in 1994) with a large accessible car park. An independent pharmacy is located at the site. Bridgwater College and Bridgwater Community Hospital (with a minor injuries unit) are both located within a short walk. Redgate Medical Centre has a sister practice, Somerset Bridge Medical Centre, located within 2 miles of this practice.

The practice has a slightly higher than England average number of patients aged under four and from 20 to 24 years of age and a lower than England average number of patients over 60 years of age. The practice has a high level of deprivation with a score of 25.8 which is higher than the England average of 23.6 and the Somerset average of 18.

The public health profile for the practice shows it has a higher rate of mortality and a much less healthy population when compared to local and national data. For example, obesity, smoking and drug and alcohol addictions are all higher than the Somerset average. Breastfeeding rates are significantly below average at 30% compared to the Somerset average of 49%.

The practice has a Primary Medical Services contract (PMS) with NHS England to deliver primary medical services. The contract is currently going through a contract review process. The practice provides enhanced services which include facilitating timely diagnosis and support for patients with dementia; childhood immunisations; minor surgery and enhanced hours patient access.

The practice team includes two GP partners (both male) and three salaried GPs (one male and two female. The practice has two full time GP vacancies. In addition the practice team comprises of a female advanced nurse practitioner, five female and one male practice nurse, a health care assistant, a practice manager, two duty managers, and data manager and part time administrative staff which include receptionists and secretaries and prescribing clerks. Most of the staff work across this practice and the sister practice.

The GPs had special interests and additional skills in areas including skin diseases, minor surgery, and hospice care.

The practice is open between 8am to 6pm Monday to Friday. Appointments are bookable six weeks in advance and are for 15 minutes each. The national GP patient survey (January 2016) reported that patients were satisfied with the opening times. Patients reported they were slightly less than satisfied with making appointments.

The practice has opted out of providing Out Of Hours services to their own patients. Patients can access NHS 111 and Somerset Doctors Urgent Care provide an Out Of Hours GP service.

Updated 20 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Redgate Medical Centre on 19 January 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 told us they were updated at the beginning of each shift with practice concerns or risks.

• 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.
• Routine patient appointments were for fifteen minutes.
• 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.
• 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. (Duty of Candour is a legal duty to ensure providers are open and transparent with people who use services. It also sets out specific requirements providers must follow when things go wrong with care and treatment, including informing patients about the incident, providing reasonable support, providing truthful information and an apology when things go wrong).

We saw areas of outstanding practice:

• The practice understood the patient population and used proactive approaches to improve patient wellbeing and physical health. For example, the provision of a weight management group, a weekly walking group, primary medical services at the local college and a support and advice drop in clinic for male students at the local college.

• The practice provided a support service for vulnerable patients and carers which included a number of initiatives. For example, the practice hosted Age UK fortnightly drop in clinics and a local carer’s support group; the practice worked with a carer’s voluntary organisation that contacted and supported all carers on the practice list.

• The practice provided staff with additional training and skills. For example, to manage insulin initiation which provided good continuity of care and reduced the need for involvement of the secondary care team. In addition diabetic patients received a mobile phone number where a practice nurse was available for support 24 hours a day.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 20 May 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.

• The practice had higher than average prevalence rates for diabetes and respiratory diseases. Data showed performance for reviewing patients with diabetes related indicators was comparative to local and national averages.

• 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 20 May 2016

e 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 patients who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.

• Patients told us children and young patients were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• The practice worked with the local college to provide nurse led primary medical services on campus.

• 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 20 May 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 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.

Updated 20 May 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 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 reflecting the needs for this age group.

Updated 20 May 2016

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

• Data showed performance for patients living with dementia and poor mental health was comparable to local and national averages.

• Patients with a mental health diagnosis received an annual birthday review.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.

• The practice carried out advance care planning for patients living with dementia.

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

• Staff had received training and had a good understanding of how to support patients with mental health needs and dementia.

Updated 20 May 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.

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

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations. Support organisations provided drop in support groups at the practice.

• 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.