Bannockburn PMS

Updated 18 August 2016

Bannockburn Surgery is situated in a property converted from two terrace houses in a residential area of Plumstead, in the Royal Borough of Greenwich. Greenwich Clinical Commissioning Group (CCG) are responsible for commissioning health services for the locality.

The practice is registered with the CQC as a Partnership. Services are provided from one location at 20 – 22 Bannockburn Road, Plumstead, London SE18 1ES. Services are delivered under a Personal Medical Services (PMS) contract. The practice is registered with the CQC to provide the regulated activities of family planning; maternity and midwifery services; treatment of disease, disorder and injury and diagnostic and screening procedures.

The practice has 5603 registered patients. The practice age distribution differs from the national average. The practice has a larger than average patient population for the 0 – 5 and 20 - 39 year age groups and a lower than average population over 45 years. The surgery is based in an area with a deprivation score of 4 (with 1 being the most deprived and 10 being the least deprived).

Clinical services are provided by two full time female GP partners; one part-time female GP partner (0.81 wte); one part-time female GP locum (0.21 wte) and two Practice Nurses (1.27 wte).

Non clinical services are provided by a practice administrator (0.9 wte), six part-time administration and reception staff (4.42 wte) and a housekeeper (0.4 wte).

The practice provides the following Directed Enhanced Services (DES): Childhood Vaccination and Immunisation Scheme; Extended Hours Access; Facilitating Timely Diagnosis and Support for People with Dementia; Influenza and Pneumococcal Immunisations; Learning Disabilities; Minor Surgery; Patient Participation; Risk Profiling and Case Management; Rotavirus and Shingles Immunisation and Unplanned Admissions. (Enhanced Services are services which require an enhanced level of provision above what is expected under a core contract).

Two of the partners provide teaching, mentoring and placements at Bannockburn Surgery for medical students from Kings College London.

The surgery is open between 08.00 and 18.30 hours Monday to Friday with extended hours provided from 07.00 to 08.00 hours on Tuesday and from 18.30 to 19.30 hours on Tuesday and Thursday.

Pre-booked and urgent appointments are available with the GP on Monday from 08.30 to 18.00 hours; Tuesday from 07.00 to 19.30 hours; Wednesday from 09.00 to 11.30 and 16.00 to 18.00 hours; Thursday from 11.30 to 13.30 and 16.00 to 19.30 hours and on Friday from 10.30 to 12.30 and 16.00 to 18.00 hours.

A Walk-in service is available with the practice nurse from 09.00 to 11.30 hours Monday to Friday.

Pre-booked appointments are available with the practice nurse between 13.00 and 17.30 hours Monday to Friday.

Extended hours are provided from 07.00 to 08.00 hours and from 18.30 to 19.30 hours on Tuesday and from18.30 to 19.30 hours on Thursday.

When the surgery is closed GP services are available via NHS 111.

A practice leaflet was available and the practice website (www.bannockburnsurgery.co.uk)

included details of services provided by the surgery and within the local area.

Updated 18 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bannockburn Surgery on 5 May 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• The provider should keep a record of batch numbers of blank prescriptions placed in printers.

• The provider should review how patients with caring responsibilities are identified and recorded on the clinical system to ensure information, advice and support is made available to them.

• The provider should carry out an annual infection control audit.

• The provider should review arrangements for patients to access a male GP if requested.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 18 August 2016

The practice is rated as good for the care of people with long-term conditions.

• The practice nurse worked collaboratively with the GPs in the management of patients with long-term conditions.

• Patients at risk of hospital admission were identified as a priority.

• Performance for diabetes related Quality Outcomes Framework (QOF) indicators was100% which was above the Clinical Commissioning Group (CCG) average of 81% and national average of 89%. Exception reporting for this indicator was 0.4% which was below the CCG and national averages. (Exception reporting is the removal of patients from QOF calculations where, for example, the patients are unable to attend a review meeting or certain medicines cannot be prescribed because of side effects).

• Longer appointments and home visits were available when needed.

• Patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For those patients with the most complex needs the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

• All patients with a diagnosis of cancer were contacted shortly after they had been diagnosed to arrange an appointment for a review with their named GP who would then be available to offer support throughout their illness.

Updated 18 August 2016

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.

• Immunisation rates were relatively high for all standard childhood immunisations.

• 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.

• The percentage of women aged 25 - 64 years who had a cervical screening test performed in the preceding five years was 82% which was comparable to the national average.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• A weekly GP walk-in clinic for children was available for non-urgent appointments.

• We saw positive examples of joint working with midwives and health visitors.

Updated 18 August 2016

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.

• The practice was responsive to the needs of older people. Extended appointments, home visits and urgent appointments were available for those with enhanced needs.

• Annual home visits, to carry out annual reviews and flu vaccination, were available for the housebound.

• All unplanned admissions were monitored and followed-up.

Updated 18 August 2016

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. Online ordering of prescriptions, appointment booking and email communication were available.

• A full range of health promotion and screening was available that reflected the needs for this populationgroup.

• Early morning and evening appointments were available.

Updated 18 August 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• 100% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the preceding 12 months which was above the national average of 84%. The exception reporting rate for this indicator was 0% which was below the CCG average and national average.

• 100% of patients diagnosed with a mental health disorder had a comprehensive agreed care plan documented in the preceding 12 months, which was above the national average of 88%. The exception reporting rate for this indicator was comparable to the CCG and national average.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice told patients experiencing poor mental health how to access various support groups and voluntary organisations.

• The practice had a system in place to monitor and follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 18 August 2016

The practice is rated as good 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, travellers and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients 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 safeguarding responsibilities regarding information sharing, documentation of concerns and how to contact relevant agencies.

• The practice carried out annual health checks for people with a learning disability.