Archived: Charlotte Keel Medical Practice

Updated 19 February 2015

The Seymour Medical Practice is located within the Charlotte Keel Health Centre at Seymour Road Easton Bristol BS5 0UA. The practice is part of the Bristol Clinical Commissioning Group and is situated in the inner city area of Bristol.

The practice shares the Charlotte Keel Health Centre facilities with another GP practice, a community dental service and community health services. Facilities include consulting rooms, a phlebotomy room (for carrying out blood tests) a shared reception and waiting area. The nurse treatment room facilities are shared with the other GP practice. There is level access into the practice and to all patient areas. Toilets are accessible with separate facilities for patients with disabilities and a separate baby changing area. Parking is available on site and close to the practice. There are a range of administrative and staff areas including a meeting area on the first floor of the building. There is lift access to the first floor. The practice is a registered GP training location.

Seymour Medical Practice has approximately 12600 patients registered with a range of cultures and ethnicity. The breakdown of patients age at the practice is:

0-16 years old 21%

16-65 years old 66%

65-74 years old 9%

75 + years old 4%

The practice is in an area of high deprivation with Income Deprivation Affecting Children (IDAC) at 48.0% over twice the national average, and a high level of child emergency admissions for asthma, diabetes and epilepsy. The patient demographic shows high number of younger adults on the patient list with high levels of unemployment and poverty. Living in relative poverty means that families tend to make lifestyle choices that are less healthy than those made by more affluent families. This is indicated by the number of patients with long term conditions. The practice provides additional services planned to meet the specific health issues of the patient group such as those related to smoking, diabetes, obesity, and chronic obstructive pulmonary disease.

There are a number of different ethnicities and languages within the population of the practice. For example, 15% of patients have a South Asian ethnicity, 10% have a Black African ethnicity and 9% are of Afro Caribbean descent. There is an interpreter service onsite to assist with any translation issues and the practice can access Big Word for telephone translation services. 57.81 % of patients come from a Black Minority Ethnic background.

The practice is made up of six GP partners and one nurse partner with six salaried GP’s of both genders working alongside nurse practitioners, qualified nurses and health care assistants (all female).

The Seymour Medical Practice is accessible by telephone throughout the day from Monday to Friday from 8.00am to 6.30pm. Appointments may be made by telephone, by calling at the practice or online. Telephone triage requests are taken throughout the day from 8am to 6.30pm to allow GPs to assess urgent requests for care and deal with them appropriately. Urgent practice nurse appointments or telephone consultations are available on request. Planned routine appointments are released a week in advance for GPs and a month in advance for Practice Nurses. The practice has an extended hours contract which means they offer appointments with nurses and GPs every Wednesday evening from 6.30pm to 8pm and alternate Saturday mornings from 9am to 12.30pm. These appointments are only bookable in advance; there are no urgent appointments at these times. The Practice Nurses offer same day appointments or telephone consultations as requested for urgent problems.

The practice does not provide out of hours services to its patients, this is provided through Bris Doc.

The practice has a Personal Medical Services (PMS) contract to deliver health care services, the contract includes enhanced services such as extended opening hours. This contract acts as a basis for arrangements between the NHS Commissioning Board and providers of general medical services in England.

The CQC intelligent monitoring data placed the practice in band one. The intelligent monitoring tool draws on existing national data sources and includes indicators covering a range of GP practice activity and patient experience including the Quality Outcomes Framework (QOF) and the National Patient Survey. Based on the indicators, each GP practice has been categorised into one of six priority bands, with band six representing the best performance band. This banding is not a judgement on the quality of care being given by the GP practice; this only comes after a CQC inspection has taken place.

Updated 19 February 2015

Letter from the Chief Inspector of General Practice

Seymour Medical Centre in situated in the inner city area of Bristol with approximately 12600 registered patients. We undertook a comprehensive announced inspection on 9 December 2014. Our inspection team was led by a Care Quality Commission (CQC) Lead Inspector, a practice nurse specialist advisor, an expert by experience and GP specialist advisor.

Before visiting, we reviewed a range of information we held about the practice and asked other organisations to share what they knew. This included the Bristol Clinical Commissioning Group (CCG), NHS England and Healthwatch.

The overall rating for Seymour Medical Practice is good. Our key findings were as follows:

• Patients were able to get an appointment when they needed it.
• Staff were caring and treated patients with kindness and respect.
• Staff explained and involved patients in treatment decisions
• Patients were cared for in an environment which was clean and reflected good infection control practices.
• Patients were protected from the risks of unsafe medicine management procedures.
• The practice had the appropriate equipment, medicines and procedures to manage foreseeable patient emergencies.
• The practice met nationally recognised quality standards for improving patient care and maintaining quality.
• The practice had systems to identify, monitor and evaluate risks to patients.
• Patients were treated by suitably qualified staff.
• GPs and nursing staff followed national guidance in the care and treatment provided.

We saw several areas of outstanding practice including:

• Seymour Medical Centre was proactive with future planning and development of services for patients. For example they had introduced a new access project to improve access to medical consultations for patients through a system of triage by GPs.
• Seymour Medical Practice worked in partnership with the local drug project to offer a shared care programme for patients with substance and alcohol misuse. The practice offered regular open clinics for patients with intravenous drug use to be tested for hepatitis.
• The practice participated in innovative programmes such as the tele dermatology project through which the practice accessed specialist dermatological advice for patients.
• We were told about the diabetes ‘drop in’ educational programme which can be accessed by any patient. This programme offered additional information and support with specific aspects of living with diabetes such as foot care.
• The practice ensured frail older patients were assessed for their potential risk of falling.
• Each month a surgery for carers was held to address any issues they may have.
• We were told about how the practice held focussed sessions to support patient whose circumstances may make them vulnerable. We saw this had been used for the Roma and the Somali communities to educate patients about immunisations and to give them confidence to use healthcare services.
• Clinicians from the practice had recorded short videos for the practice website which advised patients on minor illnesses.
• Seymour Medical Centre participated in national medical research through the Clinical Research Network programme a recent project was screening patients taking long term aspirin for helicobacter.

However, there was an area of practice where the provider needs to make improvement.

The provider should:

• Ensure that the recruitment process is fully implemented for all staff.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 February 2015

The practice is rated as good for the care of people 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. All of these patients had a named GP and a structured annual review to check that their health and medicine needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 19 February 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 compared to the national average. 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. Emergency processes were in place and referrals were made for children and pregnant women whose health deteriorated suddenly.

Updated 19 February 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 older people in its population and had a range of enhanced services, for example, the practice ensured the frail older patients were assessed for their potential risk of falling and responded as needed. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 19 February 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 reflected the needs for this age group.

Updated 19 February 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with a diagnosis of (dementia). The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations including MIND and SANE. Patients who had attended A&E where they may have been experiencing poor mental health would be offered a follow up appointment at the discretion of the GP involved.It 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. Staff had received training about how to care for people with mental health needs and dementia.

Updated 19 February 2015

The practice is rated as outstanding for the care of people whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable circumstances including homeless people and those with a learning disability. We were told about how the practice held focussed sessions to support patients whose circumstances may make them vulnerable. We saw this had been used for the Roma and the Somali communities to educate patients about immunisations.

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. The practice had carried out annual health checks for people with a learning disability which 90% of these patients had attended. It offered longer appointments for people with a learning disability.

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.