Compass House Medical Centres

Updated 3 December 2015

Compass House Medical Centre provides primary medical services to people living in Brixham and the surrounding areas. The practice provides services to a primarily older patient population (over 50% of patients are aged over 65 years) and is situated in a residential coastal location.

Compass House Medical Centre provided regulated activities from two locations; Compass House Medical Centre, Brixham and Compass House Medical Centre, Galmpton. During our inspection we visited the Brixham location.

At the time of our inspection there were approximately 10,800 patients registered at the service with a team of seven GP partners – four male and three female. The practice manager was also a partner. There were four registered nurses, two phlebotomists and two health care assistants as well as a practice manager, administrative and reception staff.

Patients who use the practice have access to community staff including district nurses, community psychiatric nurses, health visitors, physiotherapists, mental health staff, counsellors, chiropodist and midwives.

Compass House Medical Centre is open between Monday and Friday from 8am until 6pm. Appointments were available on Tuesdays until 8pm. Saturday morning appointments were available from 8am – 11.30am.

Patients access out of hours care by calling NHS 111 service.

Updated 3 December 2015

Letter from the Chief Inspector of General Practice

Compass House Medical Centre was inspected on 12 May 2015. This was a comprehensive inspection.

Overall the practice is rated as outstanding.

Specifically the practice is rated as outstanding for providing responsive and well led services, and good for providing safe, caring and effective care. The practice is rated as outstanding for the care of families, people with long term conditions, and good for the population groups of older people, working age people, vulnerable people, people with mental health issues including dementia.

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

• Patients were protected by a strong comprehensive safety system, and a focus on openness, transparency and learning when things went wrong.

• Patients reported having good access to appointments at the practice and liked having a named GP which improved their continuity of care

• The practice valued feedback from patients and acted upon this and feedback from patients about their care and treatment was consistently positive

We saw several areas of outstanding practice including:

The practice had a young person friendly clinic providing easy access to anonymous chlamydia screening and a condom card scheme called the “C Card Scheme”, a confidential service which enabled patients aged 13-24 years old to get free condoms as well as sexual health information and advice. The local authority informed us that this scheme had achieved a positive impact, decreasing sexually transmitted disease and unwanted pregnancy rates within Torbay.

The practice nominated an executive GP partner on a rotational basis every three years to lead the practice and drive continuous improvement.

The practice carried out virtual clinics for patients with diabetes to support less mobile patients and to reduce patient’s frequency of visits to the practice and also to prevent unnecessary attendance in secondary care.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 December 2015

The practice was rated as outstanding for providing services to patients with long term conditions.

Of the practice population, 71% were registered as having a long term condition compared to the national average of 54%. The leadership of the practice had responded to this in a number of innovative ways. For example, the practice carried out virtual clinics for patients with diabetes to support less mobile patients and to reduce patient’s frequency of visits to the practice and also to prevent unnecessary attendance in secondary care.

All patients had been invited for an annual review and the practice held weekly diabetic specialists clinics run by the lead GP for diabetes and his diabetic nurse support team.

The practice maintained active registers of all patients with long term conditions which ensured timely access to care and ongoing review of their condition.

All patients with breathing disorders were invited for an annual spirometer and Chronic Obstructive Pulmonary Disease check and given personal care plans and issued rescue packs of steroids and antibiotics where appropriate.

Updated 3 December 2015

The practice was rated as outstanding for providing services to families, children and young people.

Same day appointments at 9.30am were available for ill children as well as appointments after school hours, during evenings until 8pm on Tuesdays or booked appointments on Saturday mornings, or at a time requested on the day. Children aged under 11 were seen automatically and not given a telephone appointment unless requested.

There was a section of the website dedicated to young people and a noticeboard solely for young people’s health information. The practice had a young person friendly clinic on a Tuesday evening and easy access to anonymous chlamydia screening and a condom card scheme which had been implemented as a result of patient feedback. This was called the “C Card Scheme”, a confidential service which enabled patients aged 13-24 years old to get free condoms as well as sexual health information and advice.

There was a strong emphasis on child protection safeguarding at the practice. Practice staff maintained close liaison with the health visiting team, midwives and school nurses including inviting them to monthly child protection safeguarding meetings.

The practice had achieved 98% of planned childhood vaccinations for its 92 registered patients aged under five years, which was higher than the CCG average of 94%.

Children’s attendances at hospital accident and emergency units were reviewed by GPs and identified on patient notes to alert GPs to high attendances. This enabled non accidental injuries to be identified and safeguarding action taken promptly if appropriate.

Updated 3 December 2015

The practice was rated as good for providing services to older patients.

The life expectancy at 80 years for male patients was higher than the national average of 79 years. Female patient’s life expectancy was 83 years which matched the national average. Fifty per cent of the practice population was aged over 65 years and the practice took account of this in its planning. All patients aged over 75 patients had a named GP and every patient over 75 years or their appointed representative could speak to their named accountable GP about their care if they had any concerns.

The practice offered home visits where appropriate and the practice computer system had identified patients who found it difficult to leave their own home to ensure a home visit would be arranged if needed.

The practice worked closely with local nursing homes and residential care homes. Care staff at these homes had been provided with a hotline number to enable immediate access to the practice.

Patients who had been newly discharged from hospital were referred to a GP who arranged contact with them within 72 hours. GPs used a risk based approach which gave priority to those patients on the unplanned hospital admissions list.

Updated 3 December 2015

The practice was rated as good for providing services to working age people.

The practice provided extended hours appointments on Tuesday evenings until 8pm as well as Saturday mornings from 9am-1pm.

The practice offered an online access to appointments and ordering prescriptions.

All patients with pre booked appointments are sent text reminders to a mobile phone if they agreed to this service.

The practice believed strongly in health promotion and provided NHS health checks for all patients on request as well as lifestyle advice.

Updated 3 December 2015

The practice was rated as good for providing services to people experiencing poor mental health.

Patients with specific needs had been identified by GPs and flagged up on the computer system to enable the reception team to routinely book them double appointments if required. The clinical team supported patients to self-refer to the depression and anxiety service when appropriate.

The practice had a proforma built into its computer system in order to prompt GPs to cover the bio-psycho-social elements of depression when seeing patients.

The practice offered annual health checks for patients on its mental health registers including those with dementia, and was taking part in the dementia directed enhanced service. The practice recognised those with enhanced needs such as dementia and had an appointed lead GP.

Updated 3 December 2015

The practice was rated as good for providing services to patients whose circumstances may make them vulnerable. All relevant patients were flagged on the practice system.

Patients with a learning disability were recorded on a register of these patients, which included details of their carers. They were reviewed annually by a GP.

The practice had patients registered care of the local Brixham Fisherman’s Mission, the Marina and a PO Box for those with no fixed abode. The practice supported an itinerant travelling population that visited Galmpton common every spring and frequented the Galmpton practice site during that time.