Brookside Group Practice

Updated 20 April 2017

Brookside Group Practice was founded in 1977 from a single handed surgery and developed into a multi-site partnership (based across three sites). It is a large urban practice with 26,800 patients. Brookside Group Practice is based in area with low unemployment and has a higher than national average GP consulting rate.

The practice population has a higher proportion of patients aged 30-59 and lower aged 60 plus, compared to the national average. There is minimal deprivation according to national data. The prevalence of patients with a long standing health condition is 48% compared to the national average of 54%.

The practice has eight GP partners and 13 salaried GPs. It currently has nine practice nurses and three health care assistants. The practice also has three pharmacists and two paramedics. There are 57 members of staff employed by the practice as patient services, administration, reception and support staff, including a practice manager and business manager. The practice is a training practice for GP Registrars. GP Registrars are qualified doctors who undertake additional training to gain experience and higher qualifications in general practice and family medicine. The practice has a General Medical Services (GMS) contract.

Brookside surgery is open for booking appointments from 8.00am - 6.30pm Monday to Friday. The Chalfont site is open from 8.30am - 5.30pm Monday to Friday but opens at 7am on Wednesdays for a walk-in blood testing clinic and extended hours appointments. The Winnersh site is open from 8.30am - 12.30pm and 2pm - 5.30pm Monday to Friday and is closed on a Thursday afternoon. There are extended hours appointments on Tuesday, Wednesday and Thursdaybetween 6.30pm - 7.30pm at the Brookside surgery and between 7am - 8am on a Wednesday at the Chalfont surgery. The Brookside surgery is open every other Saturday morning.

There is one phone line for all three sites and this is open from 8am to 6.30pm Monday to Friday.

The practice has opted out of providing out of hours services to their patients. The out of hours service is provided by Westcall service, which is accessed by calling NHS 111. Advice on how to access the out of hours service is also detailed in the practice leaflet, on the patient website and on a recorded message when the practice is closed.

Brookside Group Practice is registered to provide services from the following locations:

Brookside Close, Earley ,Berkshire, RG6 7HG

Chalfont Surgery, Chalfont Close, Lower Earley, Reading, RG6 5HZ

Winnersh Surgery, 10 Melbourne Avenue, Winnersh, RG41 5EL

The inspection team visited one of the three sites (Brookside Surgery).

This inspection is part of the CQC comprehensive inspection programme and is the first inspection of Brookside Group Practice.

Updated 20 April 2017

Letter from the Chief Inspector of General Practice

Our previous comprehensive inspection at Brookside Group Practice on 29 June 2016 found breaches of regulations relating to the safe delivery of services. The overall rating for the practice was good. Specifically, we found the practice to require improvement for provision of safe services. It was rated as good for providing caring, effective, responsive and well-led services. The full comprehensive report on the June 2016 inspection can be found by selecting the ‘all reports’ link for Brookside Group Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 28 March 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulation that we identified in our previous inspection on 29 June 2016. This report covers our findings in relation to those requirements and improvements made since our last inspection.

We found the practice had made improvements since our last inspection. On the 28 March 2017 we found the practice was meeting the regulations that had previously been breached. We have amended the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe services as well as the previous rating of good for effective, caring, responsive and well led services.

Our key findings were as follows:

• Issues with emergency medicine checks and stock had been addressed. This included ensuring that all emergency medicines required were in stock and that all medicines were in date and fit for purpose.
• All medicines and equipment was in date and fit for use.
• Blank prescription forms for use in printers and handwritten pads were handled in accordance with national guidance as these were securely stored and there were systems in place to monitor their use.
• Patient Specific Directions (PSD) were used appropriately and in accordance with national guidance.
• The practice had reviewed how they identify carers to ensure they can offer effective care and support (1.04% of the practice list); this was an improvement on the previous 0.87%.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 September 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.
• Performance for diabetes related indicators was 85% which was comparable to the clinical commissioning group average of 88% and national average of 89%.
• 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 23 September 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 relatively 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 practice’s uptake for the cervical screening programme was 82%, which was comparable to the CCG average of 84% and 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 23 September 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 identified older patients and coordinated the multi-disciplinary team (MDT) for the planning and delivery of palliative care for patients approaching the end of life. The practice was aware of the gold standards framework for end of life care and knew how many patients they had who were receiving palliative care including a palliative care register.
• We saw unplanned hospital admissions and re-admissions for the over 75’s were regularly reviewed and improvements made.
• Nationally reported data showed that outcomes for patients for conditions commonly found in older people were higher than national averages. For example, 100% of patients aged 50 or over (and who have not attained the age of 75) with a fragility fracture and confirmed diagnosis of osteoporosis, were currently treated with an appropriate bone-sparing agent. This is higher when compared to the local Clinical Commissioning Group (CCG) average (97%) and national average (92%).

Updated 23 September 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 surgery offered an early morning commuters blood taking clinic, extended late appointments were offered three days a week and a Saturday clinic was open every other week.
• 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.

Updated 23 September 2016

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

• 75% of patients diagnosed with dementia that had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the local average of 77% and the national average of 84%.
• 97% of patients diagnosed with a severe mental health issue who had a comprehensive, agreed care plan documented in the last 12 months, which was higher than the local average of 95% and the national average of 88%.
• 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 23 September 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 patients with a learning disability.
• 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.
• 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.