Belvoir Health Group Also known as Cropwell Bishop Surgery

Updated 13 September 2017

Belvoir Health Group is the registered name for a large GP practice comprising of three GP surgeries in south Nottinghamshire, which provides primary care to just over 24,000 patients. The provider has one patient list. Patients register at one of the three surgeries, and generally access appointments at the surgery they are registered with. Certain services including flu vaccinations, coil fittings and minor surgery are offered across the surgeries.

The three surgeries are located within a four mile radius at:

• Cropwell Bishop, The Surgery, Fern Road,Cropwell Bishop, Nottinghamshire NG12 3BU. The provider is registered with the Care Quality Commission in regards to this location, which includes the following two surgeries.

• Bingham Surgery, Newgate Street, Bingham, Nottinghamshire NG13 8FD.

• Cotgrave Surgery, The Health Centre, Candleby Lane, Cotgrave, Nottinghamshire NG12 3JG.

Cropwell Bishop Surgery dispenses medicines to virtually all registered patients (5,250), as there is no other pharmacy provision within the practice boundary. Bingham Surgery also dispenses medicines to over 2,000 patients. Both dispensaries are open Monday to Friday from 8.30am to 6.30pm. We did not review the dispensary services as part of this inspection.

Belvoir Health Group is registered to provide the following regulated activities: Diagnostic and Screening Procedures, Treatment of Disease, Disorder or Injury, Surgical Procedures, Maternity and Midwifery and Family Planning. The practice provides primary care services via a General Medical Services (GMS) contract commissioned by NHS England and Rushcliffe Clinical Commissioning Group (CCG).

The practice population are predominantly of white British background. The practice list has a slightly higher percentage of older patients and a slightly lower percentage of younger patients than the national average. The level of deprivation within the practice population is generally low, although Cotgrave is an ex-mining town with areas of deprivation.

Belvoir Health Group is a partnership between twelve GP partners. The practice team includes a business manager, a financial administrator, nine practice nurses including a lead nurse, two specialist nurses, 7 health care assistants (HCAs) including a team leader, 1 phlebotomist, 9 dispensing staff, an operations manager, a HR and performance manager, reception and administrative staff including three team leaders, 12 GP partners (six male, six female) and four salaried GPs. This equates to 12.75 whole time equivalent (WTE) GPs and 7.43 WTE nurses working across the three practices.

The three surgeries have their own staff team, although administrative cover is provided between sites when required. The GPs and nurses are generally based and work at one practice, but provide cover at the other surgeries where needed.

The surgeries are teaching practices for medical and nursing students.

The surgeries are open Monday to Friday from 8am to 6.30pm.

Planned GP and nursing appointments times are available at varying times of the day across the three practices.

The provider opted out of providing extended hours appointments, although they are signed up (along with all other practices in Rushcliffe CCG) to provide extended GP, nursing and HCA evening and weekend hours from a number of local hub locations.

The practice opted out of providing out-of-hours services to its own patients. When the practice is closed patients are directed to NEMS Community Benefit Services Limited out- of-hours service via the 111 service.

Updated 13 September 2017

Letter from the Chief Inspector of General Practice

We previously carried out a comprehensive inspection of Belvoir Health Group, The Surgery, Fern Road, Cropwell Bishop, Nottinghamshire on 12 February 2015. The overall rating was good.

This announced focused inspection of Belvoir Health Group was carried out on 8 August 2017 as the practice had not been inspected recently, and in response to some information we received. We reviewed the practice against one of the five questions we ask about services: is the service responsive. The overall rating was good.

Our key findings were as follows:

• Belvoir Health Group understood and responded to the needs of their patient population well.

• The practice had undergone considerable changes and adopted improved ways of working to ensure the services were responsive to people's needs. For example, a new long-term conditions (LTC) programme had been implemented, which provided a more responsive and organised way of managing people’s conditions.

• The practice team were forward thinking and part of local pilot schemes to improve outcomes for patients.

• Feedback from patients about their care and treatment, and access to the service was consistently positive.

• The triage and appointment system was flexible and responsive to patients’ needs. The staff team were continually reviewing and adapting the system to meet patients' needs.

• The nursing team had been upskilled to take on additional responsibilities to meet patients’ needs. The skill mix and number of health care assistants and nursing staff had significantly increased to support the changes.

• To improve health outcomes for patients and to provide more effective management of long-term conditions, the provider had appointed two specialist nurses to work across its three surgeries.

• Concerns and complaints were listened to and acted on to ensure that appropriate learning and improvements had taken place.

• The practice implemented improvements and changed the way it delivered services in response to feedback from patients. The staff team had identified the need to provide more proactive feedback for patients with regards to changes made.

The provider should make the following improvement.

• Explore ways to further engage with all patient groups to seek their views and provide proactive feedback for patients with regards to changes made.

• Make available the minutes of recent Patient Participation Group meetings on the provider’s website and in the practice for patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 April 2015

The practice is rated as good for the care of people with long-term conditions. Patients were offered an annual health review including a review of their medicines. They also had an allocated GP to ensure their needs were being met. When needed, longer appointments and home visits were available. Patients’ with long term conditions and other needs were reviewed at a single appointment where possible, rather than having to attend various reviews. The practice kept a register of patients with complex needs requiring additional support, and worked with relevant professionals to meet their need. Patients were educated and supported to self-manage their conditions. Clinical staff had lead roles in the management of long-term conditions, having received appropriate training.

Updated 23 April 2015

The practice is rated as good for the care of families, children and young people. Priority was given to appointment requests for babies and young children. Systems were in place for identifying and following-up children at risk and living in disadvantaged circumstances. The practice worked in partnership with midwives, health visitors and school nurses to meet patients’ needs. Immunisation rates were high for all standard childhood immunisations. Children were able to attend weekend appointments outside of school hours. The practice provided maternity care and family planning services. The practice also provided advice on sexual health for teenagers, and screening for sexually transmitted infections.

Updated 23 April 2015

The practice is rated as good for the care of older people. Patients over 75 years were invited to attend an annual health check, and had a named GP to ensure their needs were being met. The practice worked closely with other services to enable patients to remain at home, where possible. The practice was signed up to an enhanced service to avoid unplanned admissions into hospital, and had identified older patients who were at risk of admissions. Care plans had been developed for such patients, which were kept under review.

A hearing loop system was available to support patients who used hearing aids. The practice was signed up to provide enhanced services for patients with dementia, and proactively screened patients to help facilitate early referral and diagnosis where dementia was indicated. To date, 82 % of patients over 65 years of age had received an influenza immunisation to reduce the risk of them developing flu in the 2014/2015 period. Home visits were offered and the dispensary provided a home delivery service, including the provision of compliance aids to assist patients to take their medicines correctly. Carers were identified and supported to care for older people.

Updated 23 April 2015

The practice is rated as good for the care of working-age people (including those recently retired and students). Patients were offered telephone consultations and were able to book non-urgent appointments around their working day by telephone or on line. Patients were also able to access appointments at weekends. The practice offered a ‘choose and book’ service for patients referred to secondary services. This provided greater flexibility over when and where their test took place, and enabled patients to book their own appointments. NHS health checks were offered to patients aged 40 to 74 years, which included essential health checks and screening for certain conditions. The practice also offered health promotion and screening appropriate to the needs of this age group.

Updated 23 April 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice held a register of patients experiencing poor mental health. Patients were offered extended or same day appointments or telephone consultations. Counselling services were held at the practice. Patients were invited to attend an annual health review, and had an allocated GP to ensure their needs were being met. The practice worked with mental health services to ensure that appropriate risk assessments and care plans were in place, and that patients’ needs were regularly reviewed. Patients were supported to access emergency care and treatment when experiencing a mental health crisis. The practice was signed up to provide enhanced services for patients with dementia, and proactively screened patients to help facilitate early referral and diagnosis where dementia was indicated.

Updated 23 April 2015

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 people with learning disabilities. Patients were offered extended or same day appointments or telephone consultations. Vulnerable patients were invited to attend an annual health review, and had an allocated GP to ensure their needs were being met. The practice worked with relevant services in the case management of vulnerable people, to ensure they received appropriate care and support. When needed, longer appointments and home visits were available. Carers were identified and offered support, including signposting them to external agencies.