Archived: Bilborough Surgery

Updated 12 July 2016

Dr Noble Phillips is a single handed GP who owns Bilborough Surgery providing primary medical services to approximately 1,443 patients through a general medical services contract (GMS). The practice is located in purpose built premises which underwent significant improvements in 2001 to increase capacity and patient facilities. The practice is accessible by public transport.

The level of deprivation within the practice population is significantly above the national average. Income deprivation affecting children and older people is also above the national average.

The clinical team comprises of one male GP and two part time practice nurses. The clinical team is supported by a part time practice manager and a team of reception and administrative staff.

The main surgery opens from 8am to 6.30pm Monday to Friday, with the exception of Thursday afternoon when the practice is closed at 1.30pm. Consulting times are from 9am until 11.45am in the morning and 4pm until 6.30pm in the afternoon, with no afternoon appointments available on a Thursday. Extended hours appointments are offered from 6.30pm to 7.30pm on Tuesdays.

The practice has opted out of providing out-of-hours services to its own patients. This service is provided by Nottingham Emergency Medical Service (NEMS) and is accessed via 111.

Updated 12 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Nobel Phillips practice on 24 March 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 within the practice. Effective systems were in place to report, record and learn from significant events.

• Risks to patients and staff were well managed and reviewed to keep in line with latest guidance.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.

• Training was provided for staff which equipped 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 told us that access to appointments was convenient and easy and that they had never been turned away, in addition 100% of patients who completed the resent GP patients survey said it was easy to get through to the surgery by phone.

• Staff embedded screening as a regular part of patients’ healthcare and as a result had a higher number of patients being screened in comparison to the local and national averages.

• 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 the GP and practice manager. The practice proactively sought feedback from staff and patients, which it acted on.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 12 July 2016

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

• Clinical staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Performance for lung disease related indicators was 98.7% which was 3.3% above the CCG average and 2.7% above the national average.

• Longer appointments and home visits were available when needed.

• All patients had a named GP and were offered a structured annual review to check their health and medicines needs were being met.

• For patients with the most complex needs, practice staff worked with relevant health and care professionals to deliver a multidisciplinary package of care. Fortnightly multidisciplinary meetings were hosted by the practice.

• The practice worked closely with a CCG employed pharmacist to assist in the reviews of patients medications.

Updated 12 July 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 living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances. The GP lead for safeguarding liaised with other health and care professionals to discuss children at risk.

• Immunisation rates were in line with local averages for all standard childhood immunisations and the practice worked with health visitors to follow up children who did not attend for 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.

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

• Urgent appointments were available on a daily basis to accommodate children who were unwell.

Updated 12 July 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. Fortnightly multidisciplinary meetings were held to review frail patients and those at risk of hospital admission to plan and deliver care appropriate to their needs.

• The practice was responsive to the needs of older people and the GP devoted considerable time to home visits and urgent appointments for those with enhanced needs.

• The practice delivered care to patients in a local care home and plans were in place for a regular weekly visit to increase the support to staff, as well as appointments as required.

Updated 12 July 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.

• Extended hours services were offered one evening per week to facilitate access for working patients. In addition to this there was the provision of weekend or evening appointments through a local scheme for all patients.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group. Uptake rates for screening were similar to or above the national average. For example, the uptake rate for breast cancer screening was 73% compared with the national average of 72%.

Updated 12 July 2016

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

• The percentage of patients diagnosed with dementia whose care had been reviewed in a face-to-face review in the preceding 12 months was 100%, compared to the CCG average of 83.87%

• The percentage of patients with poor mental health who have a comprehensive, agreed care plan documented in the record, in the preceding 12 months was 100% compared to the CCG average of 83.3%.

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

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

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

Updated 12 July 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 those with a learning disability and those at risk of a fall.

• The practice offered longer appointments for patients with a learning disability and for those who required it.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients. Fortnightly multidisciplinary meetings were hosted by the practice. In addition the practice held meetings every four to six weeks to discuss patients on their palliative care register.

• The practice informed vulnerable patients about 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 responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.