Bingley Medical Practice

Updated 7 April 2016

Bingley Medical Practice is registered with CQC to provide primary care services which include, access to GP’s, the treatment of disease, disorder or injury, family planning services, surgical procedures, diagnostic and screening procedures and maternity and midwifery services. It provides services for 12,700 patients in Bingley and is part of NHS Bradford Districts Clinical Commissioning Group (CCG). The practice has a Personal Medical Services (PMS) contract.

There are similar numbers of male and female patients on the practice list, with higher numbers of young children accessing the practice then the national average.

The practice has six GP partners and a practice manager. There are two female GPs and four male GP’s who work at the practice, , two nurse practitioners, a practice nurse manager and health care assistants.

The practice is open Monday 7am to 8pm, Tuesday to Friday from 8am to 6:30pm. Patients can book appointments up to two weeks in advance. Out of hours care is provided by Local Care Direct, they can be contacted via the surgery telephone number. A further option is to contact the NHS helpline by dialling 111 or consult NHS Direct online.

Bingley Medical Practice is located at Canalside Health Care Centre and is a LIFT (Local Improvement Finance Trust) building which also houses another GP practice. A branch of a local pharmacy Chemist and a number of BDCT (Bradford District Care Trust) services operate including Physiotherapy, District Nurses, Midwives, Health visitors, School nurses, Podiatry and Speech therapy. The practice has a branch surgery ‘Cross Flats Surgery’ located on the same site as a Residential Care home ‘Thompson Court’ at East Morton. This site was also visited as part of the inspection.

The practice population differs considerably from the Bradford Districts CCG and national age distributions. There are more older (20% aged over 65 years compared with 15% in the CCG and 17% nationally) and fewer younger patients (16% aged under 14 years compared with 21% in the CCG and 17% nationally).

One per cent of the practices population is of South Asian origin compared with 20% in Bradford. The practices Eastern European population has increased in the last few years and now makes up 1% of the population. Only 33 patients require the use of an interpreter.

Updated 7 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bingley Medical Practice on 12 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. Staff understood their responsibilities to raise concerns and report incidents and near misses.
• Risks to patients were assessed and safely 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 could book urgent appointments when they needed to and these were 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. We found positive working relationships between the staff.

• The provider was aware of and complied with the requirements of the Duty of Candour.

• The practice offered a district wide immediate access service providing advice and support to people with mental health problems.

• A&E attendances were significantly lower than the national average with prevalence at 69% of the national average (2885 attendances in 2014 from a practice population of more than 12500) the third best performing practice in the CCG.

We saw areas of outstanding practice:

• The practice provided a ‘temporary’ practice manager to ‘Bevan Healthcare’ which provides services for homeless people, people in temporary or unstable accommodation, refugees or those seeking asylum and others who find it hard to access the health care and support they need. The practice works closely with other organisations and with the local community in ensuring bespoke services are provided to meet patients’ needs.

• The practice had obtained the Leeds Clinical Teaching Excellence Award in 2012, only one other primary care organisation had achieved this ward. The award took into consideration that Imperial College of London medical students chose this practice for out of London placements. The practice offered medical student training for Year 1, 2, 5 and extended research students from the Leeds Medical School. The practice regularly had three GP registrars on placement and three of the partners were qualified trainers. Nurse mentoring was provided for nurses in training and qualified nurses. All the nurses were qualified nurse mentors for training. The practice offered work experience for A level students who hoped to study Medicine as a career.

• The practice had obtained the Quality Practice Award in 2011 via the Royal College of General Practitioners (RCGP). This involved an onsite visit which took place during a normal working day to assess the practice and interviews with members of staff.

The areas where the provider should make improvement are:

• Develop a more effective audit of the named GP prescription pads in order to make them more secure.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 April 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 held a multi-disciplinary Long Term Conditions clinic weekly

• Outcomes for patients with diabetes were similar to the national average

• Longer appointments and home visits were available when needed

• All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 7 April 2016

The practice is rated as good for the care of families, children and young people.

• Access for this group was effective as the practice was open on Mondays 7am to 8pm.

• There were systems in place to identify and follow up children living in disadvantaged

• 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 numbers of women attending for cervical screening was in line with national averages.

• Appointments were available outside of school hours and the premises were suitable for children and babies with toys available.

• We saw good examples of joint working with midwives, health visitors and school nurses.

• The practice routinely made early contact with new parents.

• There were alerts on patient records where there were active child protection plans.

Updated 7 April 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.

• We found easy access for those with poor mobility e.g. lifts and disabled parking.

• A large nursing home was located directly opposite the practice and the practice were proactively working with the home to make sure that the residents were supported appropriately.

• The practice held Palliative Care Gold Standard meetings involving District Nurses, GP’s and the Macmillan nurse.

Updated 7 April 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 had introduced some online services as well as a full range of health promotion and screening that reflects the needs for this age group.

• The practice offered a text messaging service to remind patients about appointments and consent for this was sought from patients before implementation.

Updated 7 April 2016

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

• 45% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months.
• 93% of people experiencing poor mental health have a comprehensive care plan, 85% had a record of blood pressure, 90% had a record of alcohol consumption.

• Weekly counselling sessions were offered at the practice to patients.

• The practice regularly worked with multi-disciplinary teams in the case management of people 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 may have been experiencing poor mental health, and who had attended accident and emergency.

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

• 72 Palliative care patients were on the practice register. Gold Standard Palliative care meetings were held every month.

• 112 mental health patients were recorded on the practice register. The practice had set up a service where Matrons visited care homes for proactive management (mainly for patients with Schizophrenia).

• 49 patients were on the learning disability register. Staff from the community trust attended some of these reviews and provided the practice with accessible information.

• The practice offer a district wide first response service for immediate access to advice and support for Mental Health problems.

Updated 7 April 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 people with a learning disability and annual health checks.

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

• The practice had told 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.

• We saw that seven adults were on the adult safeguarding register. There were alerts on patient records where there were active adult protection plans.