Archived: Dr Emerson and Partners Also known as Bungay Medical Practice

Updated 8 October 2015

Bungay Medical Practice serves the town of Bungay and its surrounding villages within a five mile radius. There are approximately 11,100 registered patients of which 25% are aged 65 and older. There are four GP partners and four salaried GPs. Patients have a choice of seeing a male (two) or female (six) doctor.

The nursing team consists of two nurse practitioners, a community matron, four practice nurses and three health care assistants. Clinical staff are supported by a team of approximately 31 other staff and this includes managerial roles, administrators, secretaries, reception and dispensary staff.

The practice is a training practice and holds a GMS contract. The practice have opted out of providing out-of-hours services to their own patients. This is provided by Integrated Care 24 Limited.

Updated 8 October 2015

Updated 30 April 2015

The practice had a long term conditions service led by the practice nurses. They followed up to date clinical protocols and were appropriately trained. There was a system in place to conduct reviews for patients at regular intervals and those with several conditions could be seen in one long appointment if this was more convenient. A system was in place to ensure that blood tests were taken two weeks prior to their review. 

Other diagnostic tests could be provided such as diabetes, spirometry, urine tests and ECGs. Patients can be provided with a range of written information and where appropriate, shared care plans are agreed i.e. asthma, diabetes.

A diabetes nurse specialist runs weekly clinics at the practice and nurses can offer home visits for patients who are housebound. Patients are also monitored for signs of depression, dementia and carer fatigue.

Updated 30 April 2015

Midwives from both the Norfolk and Suffolk teams run weekly clinics in the practice and pregnant women can choose their preferred hospital to have their baby. GPs usually see pregnant women on presentation and around the 26th week of pregnancy.

All new mothers are contacted by reception on receipt of their discharge summary to ask if they need a review and are booked in for their 6 week check with the GP.

The Health Visiting Team is based on site which greatly enhances the care of children aged under five years. In addition, vulnerable children are discussed at a regular meeting between safeguarding leads at the practice and the health visitors. 

The nurse-led "Same Day Clinic" is used mostly by families of young children and includes assessment of minor injuries. All pregnant women and babies under one year are booked in an urgent slot with a GP the same day. Parents anxious about a sick child will be triaged straight away and can be seen urgently if required. The practice has adopted the traffic light system for assessing ill children and also the open access form for paediatric review within 24 hours run by James Paget Hospital.

Young people can access the Same Day Clinic for any health concerns including advice about their sexual health. Pregnancy tests, test for sexually transmitted infections and emergency contraception is also available. Requests for contraception are passed onto the GP and patients can be referred on to family planning clinics in Norwich or Great Yarmouth if they prefer.

The practice offer contraceptive implants and refer patients for a vasectomy to a local service.  

Updated 30 April 2015

Approximately 25% of the patient population at the practice are aged over 65 years. In response to this the practice, with support from the local CCG, have placed a community matron based at the practice to help support this patient group. The practice had a register of over 200 patients who were at risk of unplanned admissions, all of whom had a care plan in place to help limit the need for hospital admission. These had been produced in partnership with the patients, their carers and other health and care professionals. Monthly multi-disciplinary meetings bring together community staff including ambulance and social care staff to review patients with the most current complex needs. Elderly patients are encouraged to visit the surgery if they are able to do so. There were a high number of home visits each day due the number of frail elderly patients living in rural locations. This included visits to patients living in nursing and care homes supported by the practice. Regular weekly rounds were in place for each home with a named GP to help promote continuity of care and to work in a more pro- active way to improve and manage patient's health needs.

Updated 30 April 2015

The practice offered later evening appointments on a Thursday and some early Monday morning appointments from 07.00. Patients could book appointments on-line and  email requests were also accepted. However, the wait for a routine appointment with a patient’s own GP could be from 2 to 4 weeks. Patients can usually access another GP in a more timely way although this may be a junior doctor supervised by an experienced GP.

The practice were concerned about access to the practice for this patient group. Urgent problems could be managed by the Same Day Clinic and if this became full the GPs worked into the evening until all urgent patients had been seen. This was not a long term solution and the practice had already discussed this with the Patient Participation Group. They had also had an assessment by the Doctor First team to consider changing the appointment system and were waiting for the results to see whether this would benefit the service.

Updated 30 April 2015

The practice had 224 patients on the mental ill health register at the time of the inspection. These patients were offered an annual medical review and non attendance was followed up. For patients who did not have a care plan agreed with the community mental health team, the practice developed a care plan with the patient's agreement. Patients on long term medication were provided with appropriate monitoring and medication reviews.

The practice also treated a large number of patients with anxiety and depression. This included an assessment of their psychological, medical and social needs. Further referral to the Wellbeing Service, in-house counsellors or self-help resources could be given if appropriate.

Children with mental health and behavioural problems could be referred to the Child and Adolescent Mental Health Service, health visitors, school nurse service or social services. The practice also had a role in supporting physical health checks for children on long term medication e.g. methylphenidate.

Patients with long term conditions are screened for depression and patients are offered a Mini Mental State Examination MMSE if they or their family are concerned about dementia. Patients with dementia are referred to a local memory service and carer support is offered to them through social services. The Community Matron is often involved with these patients to provide support and on-going advice. In addition the practice can access the local Dementia Intensive Support Team (DIST) for those with high level needs in order to continue to support them in their own homes for as long as possible. 

Updated 30 April 2015

The practice has a small local traveller population that use a local address as a base. They use the Same Day Clinic quite often. Nurses running the clinic have access to a named GP for advice and review of unwell patients or those who might move on.

The practice holds a register of patients with a learning disability. They are offered annual health checks. Records are flagged so these patients have double appointment slots to allow them ample time. In addition the practice plan to introduce a system whereby a member of the nursing administration team will liaise closely with patients with learning disabilities and their families to improve their continuity of care and attendance.

Patients with sensory impairment who might not respond to waiting room calls are collected from the waiting room. Waiting rooms are always checked before assuming non-attendance.

There is a small number of registered patients from Eastern European backgrounds. The practice told us that most have good language skills although translation services can be accessed if required to avoid reliance on family members.