Newbridge Surgery

Updated 3 June 2016

S J Cooper and Partners is located to the west side of the city of Bath. It serves patients living in the centre and west side of Bath and the villages surrounding the west side of Bath. The practice has a population of approximately 7,900 patients and a population with low levels of social deprivation. The practice profile it serves represents a profile similar to the clinical commissioning group and national average patient profile distribution, except for slightly lower numbers of patients between the ages of 20 to 35 year olds.

The practice is situated in a purpose built building over three floors, with all level access to the two lower floors with clinical rooms for patient access.

The practice has four GP Partners, two male and two female, three salaried GPs and is currently supporting one GP Registrar (Registrars are qualified doctors who undertake additional training to gain experience and higher qualifications in general practice and family medicine).

The practice has one nurse practitioner, two practice nurses, two health care assistants and one phlebotomist. The practice is supported by a practice manager operational lead, and practice business lead and a team of reception and administration staff.

The practice was open between 8am and 6pm Monday to Friday. Appointments were from 8.30am to 11:30am every morning and 2.30pm to 5.30pm daily although this extended to 5:45pm on varying days. Extended hours appointments were offered on alternate Saturday mornings with two GPs from 8.15am to 12pm. In addition to pre-bookable appointments that could be booked up to six weeks in advance for GPs and up to 12 weeks in advance for other services, same day urgent appointments and telephone appointments were also available for people that needed them.

The practice has a Primary Medical Services (PMS) contract to deliver health care services. This contract acts as the basis for arrangements between the NHS Commissioning Board and providers of general medical services in England.

When the practice is closed the out of hours care is provided by Bath Docotrs Urgent Care accessed via NHS 111.

The regulated activities this practice provides are available from the registered location;

Newbridge Surgery,

129 Newbridge Hill,

Bath.

BA1 3PT

When SJ Cooper and Partners was registered with the Care Quality Commission in 2013 there were two areas where minor non compliance had been recorded. These related to safeguarding and dignity and respect. Our inspection found no concerns in these areas and the practice was now compliant.

Updated 3 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at S J Cooper and Partners on 7 April 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 care and compassion 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 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 practice patient participation group were engaged with the practice and influencing and improving services for patients.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

One of the GPs had led a project with the clinical commissioning group (CCG), the local health and social care community provider and the local hospital to develop a heart failure pathway and heart failure passport for patients. This had demonstrated a reduction of 24.7% in admissions for heart failure across the local area in 2013 to 2014. The pathway had also evidenced cost savings, a reduction in length of admissions and improved patient satisfaction for these patients. This pathway and passport for heart failure had then been shared across the local CCG area and a neighbouring CCG area.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 June 2016

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

• The practice worked with other agencies to develop new care pathways to improve outcomes for patients. For example, one of the GPs had led a project with the clinical commissioning group (CCG), the local health and social care community provider and the local hospital to develop a heart failure pathway and heart failure passport for patients. This had demonstrated a reduction of 24.7% in admissions for heart failure across the local area in 2013 to 2014. The pathway had also evidenced cost savings, a reduction in length of admissions and improved patient satisfaction for these patients. This pathway and passport for heart failure had then been shared across the local CCG area and a neighbouring CCG area.

• The practice had undertaken a pilot with the CCG and the local cluster of GP practices to redesign the services for patients with diabetes as part of the CCGs transformation priorities. This pilot had improved the self-care, self-management and continuity of care for patients with diabetes.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• The percentage of patients with COPD (chronic obstructive pulmonary disease – a range of chronic lung conditions ) who had a review undertaken including an assessment of breathlessness (using the Medical Research Council dyspnoea scale) in the preceding 12 months (2014/15) was 96% which was higher than the national average of 90%.

• The percentage of patients with diabetes, on the register, who have had influenza immunisation in the preceding August to March (2014/15) was 100% compared to the national average of 95%.

• The percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) was in the target range was 90% which was higher than the national average of 78%.

• 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 3 June 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 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 percentage of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding 5 years (2014/15) was 85% which was higher than the national average of 82%.

• 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 3 June 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.

• The practice supported patients in eight care homes including the local action for hearing loss centre.

• The practice worked proactively with the community teams to provide multidisciplinary care to older patients, including referring for support from the community health visitors for older people and the social prescribing scheme to support patients holistic care needs.

Updated 3 June 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.

• The practice offered alternate Saturday morning appointments with two GP sessions running to help meet the needs of the working population.

Updated 3 June 2016

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

• The percentage of patients with a serious mental health problem who have a comprehensive, agreed care plan documented in their record, in the preceding 12 months (2014/15) was 97% which was higher than the national average of 88%.

• The percentage of patients with a serious mental health problem whose alcohol consumption has been recorded in the preceding 12 months (2014/15) was 100% which was higher than the national average of 90%.

• The percentage of patients diagnosed with dementia whose care has been reviewed in a face-to-face review in the preceding 12 months (2014/15) was 98% which was higher than the national average of 84%

• 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 3 June 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. 83% of those with a learning difficulty had had their annual health review.

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

• 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. The practice offered access to the talking therapies support service at the premises.

• 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.