Archived: Brewood Surgery Also known as Brewood Medical Practice

Updated 20 August 2015

Brewood Group Medical Practice comprises three branches, Brewood Surgery, Wheaton Aston and Coven. We carried out an announced comprehensive inspection at Brewood Surgery, the main practice site, the other two branches were not inspected as part of this visit. This semi-rural practice is based in Brewood but also serves the villages of Coven, Coven Heath, Wheaton Aston, Stretton, Lapley and Bishopswood, as well as outlying hamlets. The Brewood Group Medical Practice provides dispensary services at one of its branches. The practice has a patient list size of 10,300 over all three sites. The practice is situated within an area of less deprivation when compared to other areas in the local Clinical Commissioning Group (CCG) area of NHS Stafford and Surrounds. Its main population age group as shown in 2014 are patients aged between 45 and 85 plus with a significant number of these aged between 65 and 69.

The practice is a single storey purpose built building constructed in 1960. The building is in a very poor condition and there is limited car parking. The practice is in the process of undertaking a new practice building programme which is being funded by the GP partners. The completion date for this new build is September 2015. The plans for the new building are displayed in the main waiting area. The opening times at the practice are between 8am and 6pm Monday to Friday. Patients can book appointments in person, on-line or by telephone. Extended hours are available on Tuesday and Thursday morning between the hours of 7am and 8am and Monday, Tuesday and Friday evenings between the hours of 6.30pm and 7.30pm.

The practice provides services to patients of all ages based on a General Medical Services (GMS) contract with NHS England for delivering primary care services to their local community. Services provided at Brewood Surgery include the following clinics; family planning, new patient medicals, asthma, diabetic, baby vaccination and wellbeing screening clinics.

The team of clinical staff at Brewood Group Medical Practice consists of six practice nurses (female), two health care assistants, 4.5 WTE GP partners and 1.5 WTE salaried GPs (four male and three female), phlebotomist (a person that takes blood for tests), A practice manager, reception manager, reception, administrative and secretarial staff provide management and administration support for the practice.

Brewood Group Medical Practice is an approved GP training practice for Registrars (qualified doctors who undertake additional specialist training to gain experience and higher qualification in General Practice and family medicine). Other allied professionals and students may, on occasion, be sitting in with the doctor or nurse. The practice is also an accredited teaching and training practice for medical students and newly qualified doctors.

Primecare provides an out of hours service for patients when the practice is closed and information is provided to patients about the NHS 111 service.

Updated 20 August 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Brewood Surgery, the main branch on 12 March 2015. The other two branches were not inspected as part of this visit. Overall Brewood Surgery is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well-led services. It was also good for providing services for older people, people with long term conditions, families, children and young people, working age people (including those recently retired and students), people whose circumstances make them vulnerable. It was outstanding in areas for people experiencing poor mental health (including people with dementia).

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. However although information about safety was reported monitored and reviewed, records to demonstrate how they were addressed were not consistently recorded.
• Risks to patients were assessed and well managed with the exception of areas related to infection control and checking of equipment.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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. However verbal complaints were not recorded and monitored.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments 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 saw one area of outstanding practice:

• The practice had developed and implemented a dementia care management plan. Patients had a dedicated one hour consultation with a GP and had their clinical assessments and screening carried out by the same group of staff which ensured continuity in the staff that they saw.

However there were areas of practice where the provider needs to make improvements.

Action the provider SHOULD take to improve:

• Maintain consistent records to clearly demonstrate the discussions and actions taken to address and review safety incidents.
• Review toilet facilities to ensure that they are clean and that paper towels and suitable bins are provided.
• Review the systems in place for checking emergency equipment.
• Implement systems to record and monitor verbal complaints.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 20 August 2015

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. Longer appointments and regular home visits were available when needed. All these patients had a named GP, named lead nurse 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 GP and nurse worked with relevant health and care professionals to deliver a multidisciplinary package of care. Patients with long-term conditions who found it difficult to get to the practice had care delivered in the community where appropriate.

Updated 20 August 2015

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. 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 20 August 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. All practice nurses delivered care in the community to housebound patients and also patients who found it difficult to get to the practice.

Updated 20 August 2015

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.

Updated 20 August 2015

The practice is rated as outstanding for the care of people experiencing poor mental health (including people with dementia). Information available showed that 90.6% of people experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. There was a psychologist attached to the practice who provided support for patients who experienced poor mental health. It carried out advance care planning for patients with dementia. The practice had developed and implemented a dementia care management plan. Patients were entered into a two stage dementia assessment process and clinical assessments and screening were carried out by the same group of staff which ensured continuity in the staff that patients saw. Patients had a one hour clinical appointment with the lead GP for dementia care. The results of the project showed that the number of patients diagnosed with dementia had increased from 42 patients in September 2014 to 77 patients at the time of inspection. Improved outcomes noted for newly diagnosed patients included timely access to memory clinics and an increase in the appropriateness of referrals.

Updated 20 August 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice held a register of patients with a learning disability. It had carried out annual health checks for people with a learning disability and all of these patients had received a follow-up. It offered longer appointments for people with a learning disability. The practice did not have a register of patients living in vulnerable circumstances such as homeless people or travellers, but would offer a service to patients if needed.