Hillview Family Practice Also known as Dr Montague & Partners

Updated 10 January 2017

Hillview Family Practice is located in a suburban area of Bristol where there is higher than average deprivation. They have approximately 6100 patients registered.

The practice operates from one location:

Hartcliffe Health Centre

Hareclive Rd,

Bristol

BS13 0JP

It is sited in a purpose built one storey building. The consulting and treatment rooms for the practice are situated off the main reception and waiting room area. The practice has five consulting rooms; there are two treatment rooms for use by the practice nurse and health care assistant. There is a second treatment room area and waiting area which is shared and managed by the Hartwood Health practice. The building is also shared with services provided through Bristol Community Health who manage the site. There is limited patient parking immediately outside the practice with spaces reserved for those with disabilities.

The practice is made up of four GP partners and one salaried GP and the practice manager, working alongside a qualified nurse and a health care assistant. The practice is supported by an administrative team made of a business manager, medical secretaries, receptionists and administrators.

The practice was open for urgent and routine appointments between 8.30am – 12.30pm and 1.30 –6.30pm. Urgent appointment requests will be seen the same day and routine appointments will be given at the first available time. They provide four hours per week of extended hours. This is split early mornings from 7.30 – 8.30am and evenings 6.30 – 7.30 pm. The service also offered ‘same day’ phlebotomy appointments.

The practice has a Personal Medical Services contract with NHS England (a locally agreed contract negotiated between NHS England and the practice). The practice is contracted for a number of enhanced services including extended hours access, facilitating timely diagnosis and support for patients with dementia, patient participation, immunisations and unplanned admission avoidance. The practice does not provide out of hour’s services to its patients, this is provided by BrisDoc. Contact information for this service is available in the practice and on the website.

Patient Age Distribution

% aged 0 to 4 years: 8.9% - higher than the national England average.

% aged 5 to 14 years: 13.9% - higher than the national England average.

% aged under 18 years: 18.1% - higher than the national England average.

% aged 65+ years: 11.8% - lower than the national England average.

% aged 75+ years: 5.9% - lower than the national England average.

85+ years old: 1.4% - lower than the national England average.

Patient Gender Distribution

Male patients: 49.5 %

Female patients: 50.5 %

Other Population Demographics

% of Patients in a nursing Home: 0.56 %

% with health-related problems in daily life - the practice value 64.3% compared to the national average of 48.8%.

Disability allowance claimants (per 1000) - the practice value is 96 compared to the national average of 50.3.

Working status – Unemployed - the practice value is 12.6% compared to the national average of 6.2%.

The practice is in South Bristol which has the highest number of people with a long term health problem or disability in each age category in Bristol and the highest % of long term conditions.

Hillview Family Practice offers 45,690 appointments per year, a consultation rate of 7.7 per weighted patient. The national average is 5.5, 32,752 appointments for the weighted patient population (as last measured by the HSCIC QResearch report in 2009), therefore the practice delivers an excess of 12938 appointments above the national average. This is in part due to increased levels of prevalence and also due in part to deprivation and general increased demand on services.

Updated 10 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hillview Healthcare on 3 December 2015. Following our comprehensive inspection the practice was rated as overall good with requires improvement for the effective domain. Following the inspection we issued a requirement notice. The notice was issued due to a breach of Regulation 17 of The Health and Social Care Act (Regulated Activity) Regulations 2014, Good governance.

The issue was:

• Regulation 17, the provider did not have a system in place for undertaking clinical audits which would demonstrate the quality of the service provision

A copy of the report detailing our findings can be found at www.cqc.org.uk.

We carried out an announced focused inspection at Hillview Family Practice on 4 October 2016 to follow up the requirement notice in order to assess if the practice had implemented the changes needed to ensure patients who used the service were cared for by an effective service.

Our key findings across all the areas we inspected during this inspection were as follows:

• The provider had implemented a system for undertaking clinical audits and had demonstrated that they had used the information to check, and where necessary improve the quality of the service.

Following this inspection the practice was rated overall as good and good across all domains.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 4 February 2016

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had specialist training for the management of chronic disease management and patients at risk of hospital admission were identified as a priority.
• The percentage of patients with diabetes, on the register, whose last measured total cholesterol (measured within the preceding 12 months) is 5 mmol/l or less (01/04/2013 to 31/03/2014) was 82.82% compared to the national average of 81.6%.
• 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 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 4 February 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 was part of the for young people (4YP) scheme which enabled young people to access sexual health advice.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 4 February 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 patients in its population and had a range of enhanced services, for example in dementia, influenza and pneumococcal Immunisations.
• It was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• The practice was part of a scheme working with the charity Retired and Senior Volunteer Programme (RSVP) in the area to help to provide social support to their patients who were living in vulnerable or isolated circumstances.
• The practice accessed the Rapid Assessment Clinic for Older people based at the local community hospital and assigned a GP to attend sessions in which to observe the consultant and then take the learning to the practice to share with colleagues.

Updated 4 February 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 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.
• The practice was a leading practice in the Bristol Clinical Commissioning Group area for undertaking NHS health checks.
• The practice participated in the eConsult (formally Web GP) scheme which provided online consultations.

Updated 4 February 2016

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

• 92.59% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months.
• 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 4 February 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 patients, travellers and those with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients.
• 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 and had attended training in order to recognise signs of domestic violence.
• 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.