Background to this inspection
Updated
5 July 2018
The partnership of GPs registered as Brannam Medical Centre runs one registered location at the Brannam Medical Centre, which was inspected on 4 May 2018. This was a comprehensive inspection.
The practice is located at:
Brannam Medical Centre
Brannam Square
Kiln Lane
Barnstaple
Devon
EX32 8GP
The practice provides a primary medical service to 16,150 patients of a diverse age group. The practice population is in the fifth deprivation decile for deprivation. In a score of one to ten the lower the decile the more deprived an area is. Particular areas of Barnstaple and the surrounding villages have higher levels of deprivation. There is a practice age distribution of male and female patient’s equivalent to national average figures. Average life expectancy for the area is similar to national figures with males living to an average age of 80 years and females to 83 years.
There is a team of 12 GPs partners, supported by a salaried GP and two GP retainers (seven male and eight female). Three of the GP partners job share. The team are supported by a practice manager, six practice nurses, three healthcare assistants and a part time clinical pharmacist. There are administrative and reception staff.
Brannam Medical Centre is an approved training practice providing vocational placements for GPs registrars. Four GP partners are approved to provide vocational training for GPs, second year post qualification doctors and medical students. A GP registrar was on placement when we inspected with this increasing to three from August 2018. Teaching placements are provided for medical students, post qualification doctors, student nurses, paramedics and physician assistants.
Patients using the practice also have access to community nurses, mental health teams and health visitors. Other health care professionals visit the practice on a regular basis.
The practice is open between 8am and 6:30pm Monday to Friday. Appointments are available from 8am every morning and 6pm daily. Extended hours opening is available on a Tuesday to Friday from 7am to 8am and 6.30pm to 8pm on Mondays. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments. Outside of these times patients are directed to contact the out of hour's service by using the NHS 111 number.
Updated
5 July 2018
This practice is rated as Good overall. (Previous inspection November 2014 – Good)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Outstanding
Are services well-led? - Good
We carried out an announced comprehensive inspection at Brannam Medical Centre on 4 May 2018. The inspection was a routine inspection as part of our inspection schedule.
At this inspection we found:
- The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved processes.
- Audit was embedded, with the practice routinely reviewing the effectiveness and appropriateness of the care it provided. Care and treatment was always delivered according to evidence-based guidelines.
- All 30 patients gave strongly positive feedback at the inspection about staff treating them with compassion, kindness, dignity and respect.
- Staff were caring and raised funds for local charities every year.
- People’s individual needs and preferences were central to the planning and delivery of flexible tailored services. All patient feedback highlighted ease of access to the appointment system, on the day assessment and minor illness services. Extended hours were available every day enabling working patients and school children to access a range of services from the multi-disciplinary team.
- As a training practice, there was a strong focus on continuous learning and improvement at all levels of the organisation. Proactive succession planning based on staff development and training of future GPs, doctors and practice nurses was evident.
- Brannam Medical Centre had successfully registered a further 1650 additional patients in 2017/18 due to the closure of a nearby practice. The practice list size had increased by 3,000 in the last three years. Patient feedback shared with us by patient representatives indicated existing patients had reported no adverse impact for them.
We saw areas of outstanding practice including:
A housebound patient pathway was developed and adopted locally, enabling vulnerable patients with long term conditions to have comprehensive regular reviews at home carried out by the practice nurse and pharmacist. In total 160 patients, had regular reviews of their health by these staff and received proactive support to reduce any associated risks.
In response to patient need, the practice had set up in-house free counselling service for patients, in conjunction with the local college. Sixty patients with long term conditions, including obesity were able to access support between April 2017 and March 2018. This was in addition to hosting the secondary care depression and anxiety services at the practice for patients.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice