Archived: Bevan House

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bevan House on 4 February 2016. Overall the practice is rated as outstanding.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• Risks to patients were assessed and well managed.
• Feedback from patients about their care was consistently and strongly positive.
• Information about how to complain was available and easy to understand.
• The practice had introduced numerous ways to improve access to services including a walk-in triage service each morning for those without access to a telephone, or who due to language difficulties could not make a telephone appointment.
• An Arabic interpreter was available at the practice until 1pm each day to assist patients.
• Volunteers assisted patients with registration forms and accompanied people to appointments with other service providers for example housing agencies and multi-lingual volunteers were able to interpret for patients.
• The practice had trained Heath Champions who were or had been patients at the surgery, they offered help and advice to patients and organised healthy living and health promotion events.
• The practice had a clear pro-active vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed with them and the staff team.
• The Bevan House team were winners of the 2015 General Practice Awards for Innovators of the Year.

We observed numerous examples of outstanding practice.

• Dedicated teams within the practice worked closely with other organisations in ensuring bespoke services were provided to meet patients’ needs. For example, the Bevan Pathway Team attended regular meetings at the local hospital to review its patient group and improve patient discharge and the provision of care and support.
• The Street Medicine Team held mobile outreach clinics in city centre locations to enhance access for vulnerable patients and also offered advice and healthcare to people who were not registered with the practice.
• The Bradford Respite and Intermediate Care Support Service (BRICCS) is a respite service that has been developed, where the Bevan team work with a social housing provider to offer respite accommodation for homeless patients who require medical care after they are discharged from hospital. These initiatives led to an increase in the number of homeless people registering with the practice, a reduction in the use of acute healthcare, A&E admissions and days spent in hospital. The intervention of these teams with homeless patients has shown significant cost savings in acute care of 62%.
• The practice had organised a Christmas celebration for vulnerable children who were registered with them. The staff team had donated presents for the children which were distributed by a member of the team dressed as Santa Claus.
• Feedback from the Patient Participation Group called the Experts by Experience (ExE), was integral to the running of the practice. Their views were actively sought and valued. The practice held numerous patient focus groups to find out their views on topics such as diabetes care. The group had been involved in the design, build and decoration of the new premises.
• A late evening clinic ran for three evenings per month from 8pm to 11pm for female sex workers and one early morning clinic, in liaison with a local women’s support team. Over 70% of the women who attended the late night sex workers’ clinic had registered with the practice and were accessing extended services.
• The practice had recruited a mental health nurse and a vulnerable migrants nurse, to work alongside a practice nurse, to effectively support patients. This had enabled the practice to be prepared to meet the needs of new patients, conduct structured assessments and refer as necessary to relevant services, prior to the persons arrival in the country.
• The practice had moved to new premises that allowed it to host other services and provide a “one stop shop” for patients. The teams located in the practice included the homeless team, benefits services, refugee support workers, rape crisis, legal, housing, midwifery and health visiting teams.
• Staff were clearly motivated and inspired to offer kind and compassionate care and worked to overcome obstacles to achieving this. Clothing, food, oral and personal hygiene packs and ‘cold weather packs’ (consisting of gloves, socks, a hat, scarf, water and a bar of chocolate) were offered to those patients who were in urgent need.
• All staff had been given the opportunity to participate in individual Life Coaching sessions, to provide guidance and support as needed.
• The practice patient liaison lead and the ExE group held a weekly Chat and Craft group where patients, refugees and homeless people could meet new people and learn about services. Participants also knitted small articles for the homeless.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice