Archived: Belgrave Surgery

Updated 22 January 2015

Belgrave Surgery, Lawrence House Medical Centre, 1 Belgrave Crescent, Scarborough, YO11 8RZ is situated in Scarborough town centre. The registered patient list size of the practice is 4,935 of which 2,436 are male and 2,499 are female. The overall practice deprivation is higher than the England average.

There are two GP partners and two salaried GPs. The clinical team is made up of a senior practice nurse, a practice nurse and two health care assistants. There is practice manager, deputy practice manager, administration team manager and a range of administration staff.

Belgrave Surgery is a GP training practice.

The practice has a general medical service (GMS) Contract under section 84 of the National Health Service Act 2006. The NHS Commissioning Board and the practice enter into a general medical services contract under which the practice is to provide primary medical services and other services in accordance with the provisions of the Contract.

The practice has opted out of providing out-of-hours services to their own patients. Patients use the 111 service when the practice is closed. Patients are seen by Primecare out of hours.

Updated 22 January 2015

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of Belgrave Surgery on 4 November 2014.

We rated the practice overall as Good.

Our key findings were as follows:

• Staff reported incidents and learning took place. The practice had enough staff to deliver the service.  Services were delivered using evidence based practice.

• Staff were caring and compassionate. Patients told us they were treated with dignity and respect.
• The practice was responsive to the needs of patients and took into account any comments, concerns or complaints to improve the practice.

• The practice was well led, with an accessible and visible management team with clear direction. Governance systems and processes were in place and quality management information was available and used to improve outcomes for patients.

We saw two areas of outstanding practice including:

• The practice was linked with Scarborough University Campus. The practice staff attended Fresher’s week at the University where they offered on campus health assessments for students who wished to register. Students were provided with health information packs. Health and well-being events also took place at the University throughout the year and the practice worked in conjunction with the University Counselling Service.
• Clinical and reception staff had used their initiative when they had raised a concern about a vulnerable patient to other agencies which led to a positive outcome for the patient. The practice had been commended by the Domestic Abuse Team.

However, there were also areas of practice where the provider needed to make improvements.

Importantly, the provider should:

• Ensure that all emergency medication is within its expiry date.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 January 2015

The practice is rated as good for the care of patients with long-term conditions. There were emergency processes in place and referrals were made for patients whose health deteriorated suddenly. Longer appointments and home visits were available when needed. Clinical staff specialised in areas such as Heart Failure, chronic obstructive pulmonary disease (COPD), Diabetes and Asthma. The practice offered specific nurse led clinics for patients with long-term conditions. The practice had an effective recall system in place. Nationally reported data showed the practice was proactive in identifying and monitoring patients with long-term conditions.

Updated 22 January 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 who were at risk, for example, children and young people who had a high number of A&E attendances. The practice offered a full range of immunisations for children. Immunisation rates of children who were eligible for immunisations at aged 12 months that received immunisations was slightly below the CCG average and the percentage of children aged 24 months and 5 years who were eligible for immunisations that receive immunisations and at 24 months and aged 5 years was slightly above the CCG average.

Appointments were available outside of school hours.  The premises were suitable for children and babies. The practice worked jointly with the community midwife and health visitor; with both being based at the practice. The practice had two trained GPs who offered regular contraception clinics and sexual health advice. Emergency processes were in place and referrals were made for children and pregnant women whose health deteriorated suddenly.

Updated 22 January 2015

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 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 patients over 75 years of age had a named GP and a care plan. The practice had identified all patients who were Veterans. The practice had recently recruited a nurse practitioner who they planned would lead on the care of the over 75 year olds and to work with residential and nursing homes to reduce A&E admissions. Immunisations were offered to this group of patients; for example shingles. Immunisation rates were equal to the national average for flu vaccines in patients over 65 years.

Updated 22 January 2015

The practice is rated as outstanding for the population group 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 offered extended appointments from 8am to 8pm Monday to Friday in partnership with Falsgrave Surgery. The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group. The practice was linked with Scarborough University Campus. The practice staff attended Fresher’s week at the University where they offered on campus health assessments for students who wished to register. Students were provided health information packs. Health and well-being events also took place at the University throughout the year and the practice worked in conjunction with the University Counselling Service.

Updated 22 January 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The number of patients experiencing poor mental health who had received an annual physical health check was higher than the national average. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health; for example the Addictive Behaviour Service (ABS) and Primary Care Mental Health Worker (CAMHS). Patients could access this service at the practice on a weekly basis. The practice had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. The practice worked with the University Counselling Service to utilise their services.

Updated 22 January 2015

The practice is rated as good for the care of patients whose circumstances may make them vulnerable. The practice held a register of patients with a learning disability and carried out annual health checks for these patients either at the practice or in their home. Easy read literature was made available for patients; for example when having a cervical smear. The practice also offered longer appointments for people with a learning disability. The practice held a register of vulnerable patients who may be at risk of unplanned admissions. All these patients had a care plan in place.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It 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. 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.