Archived: Northville Family Practice

Updated 19 February 2015

Northville Family Practice is a partnership shared by three practising GPs. The practice has three salaried GPs, practice nurses and healthcare assistants. The practice manager is supported by administrative staff and receptionists. The practice is situated in a largely residential area of South Gloucestershire. The patient population is mixed with young families, patients of working age and older patients. The practice is close to the University of West of England and provides services to some students.

All of the GPs work on a part time basis providing a service on weekdays from 8.30 am until 6pm. There are extended hours on aThursday to offer early morning appointments from 7.30 am for treatment and early evening consultations with a GP until 7.15pm. There are pre-bookable appointments available on some Saturday mornings usually after bank holiday weekends.

The services are provided at 521 Filton Avenue, Northville, Bristol BS7 0LS.

The practice does not provide an Out of Hour’s service. Emergency arrangements for Out of Hour’s is provided by an external service provider.

Updated 19 February 2015

Northville Family Practice provides consultations with GPs and a range of appointments for treatment. The practice is located at 521 Filton Avenue, Northville, Bristol, BS7 0LS.

Prior to the inspection we met with the South Gloucestershire Clinical Commissioning Group, NHS England, The Avon Local Medical Committee and Healthwatch South Gloucestershire. This ensured we obtained a range of intelligence from organisations that work closely with the practice. During our visit to the practice we spoke with patients and staff.

We obtained information from Public Health England that showed the practice had over 5,000 patients. These included some of Asian origin (5%) patients who were Black (3.4%), Chinese (1.7%) and of other non-white ethnic groups (2.5%). The information showed life expectancy for males as 77.6 years and 81.8 years for females.

The practice supported older patients, patients with long term conditions and those who suffered with poor mental health. In addition it provided services for mothers, babies, children and young patients along with, those of working age and the recently retired. There were some travellers registered with the practice.

We spoke with all staff on duty on the day of our visit, these included the GPs, nurses and administrative staff. We spoke with eleven patients. We also received four comments cards containing additional feedback from patients. We found the practice to provide safe, caring and effective treatment that was responsive to patient’s needs. There was effective leadership indicating the practice was well-led.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

Updated 19 February 2015

We saw patients with long term conditions could access information about the services available at the practice on the practice website. It showed that in addition to routine GP consultations the practice offered a wide range of services and information which might help patients without having to see their GP.

Services included appointments for chronic disease management such as asthma, diabetes, chronic obstructive pulmonary disease (COPD) and hypertension (raised blood pressure). Information included self-help leaflets, short video clips about diagnosed illnesses and links to other services that might be able to help or advise if the practice was closed.

The practice nurse told our GP specialist advisor they were one of two nurses who saw patients with a diagnosis of diabetes. They said they referred patients to a diabetic liaison nurse for insulin conversion (a change between taking tablets and having injections to control their diabetes) when changes to insulin was necessary.

Updated 19 February 2015

There were no maternity or ante-natal clinics held in the practice. The GPs and nurses we spoke with told us patients were referred to a clinic nearby in Filton for these services. In support of post natal care a programme of immunisation was available for children.

A parent told us the practice was good with their children and what they particularly liked was the way GPs spoke with the child rather than the parent. Another parent contacted us to say the practice was proactive and had sent a letter to arrange for their child to have a Meningitis vaccination. They felt this letter was a helpful way to make it easier for parents to take their child to the practice during the school break. The practice manager confirmed this was the intention of the practice.

We saw a General Medical Council poster in the waiting area of the practice which advised young patients about their rights when being seen by a GP. It showed that what young patients said to the GP was confidential and that GPs should be asking them first before sharing information about them with anyone else. The information stated they could decide to see the GP on their own and that they would be treated with the same respect as adults. The guideline was in line with the Gillick competency guidelines. These referred to decisions about whether a child was mature enough to make decisions for themselves and if they had the ability to be seen alone or with a chaperone rather than with their parents. Where this was the case, we were told patient records would be updated to reflect the current arrangements.

Updated 19 February 2015

The practice had considered the needs of its patients, particularly those who were elderly or who had restricted mobility. Reasonable adjustments had been made. There was level access to the practice with a ramp at the main door and level access to all surgeries and toilet.

A partner GP told us the practice aimed to prevent hospital admissions where possible and maintained connections with the clinical commissioning group (CCG). They told us how the practice shared essential information about the most vulnerable older patients with the GP out of hour’s service and ambulance service. This enabled the other services to respond appropriately to patients and help avoid unplanned hospital admissions when the practice was closed.

A programme of immunisation was available for older people who were eligible for the influenza vaccine.

We saw an older patient with a hearing impairment being greeted by the practice nurse. The receptionist had recognised their impairment and added a message to the electronic records system to alert the nurse to the patient’s impairment because they may not hear the loudspeaker announcement. We saw that the nurse came out to meet the patient when their appointment was due to commence.

An older patient we spoke with told us how they had been visited at home when needed. The staff we spoke with told us how this type of service was available to all older patients if they were unable to get to the practice for appointments.

Updated 19 February 2015

Patients could make appointments outside of their working hours. There were appointments available early morning and early evening on Thursday and some pre-bookable Saturday morning appointments.

Updated 19 February 2015

A GP partner told us about the initiatives they were involved with including the South Gloucestershire Dementia Project. The project linked the local council, clinical commissioning group and other agencies to provide information and support for people with dementia. Patients were able to be assessed in their home environment as they had an assessment at home carried out by the memory care nurse.

Updated 19 February 2015

The reception and waiting area was open however there was a ‘privacy window’ to the side of the reception where patients could talk in confidence with a receptionist.

The practice chaperone policy considered the needs of patients in vulnerable circumstances. It advised that clinicians should consider whether intimate or personal examination of a patient was justified and whether the nature of the consultation posed a risk of misunderstanding. We saw that it advised that GPs and nurses should always give the patient a clear explanation of what the examination would involve, adopt a professional and considerate manner and afford the patient sufficient privacy.