Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Thornbury Health Centre - Foubister on 19 October 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 practice should ensure that they retained all of the necessary recruitment information about the locums they employed.
• The practice should ensure that it retained an overview of how the maintenance and health and safety requirements for the premises were met.
• The practice should ensure that they have effective systems in place to identify and support carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Thornbury Health Centre, which is also known as the Foubister practice is one of two GP practices based on the same site. The site adjoins a local community hospital and GPs from the practice were responsible for overseeing some of their inpatient beds. The building was purpose built and designed to be fully accessible to patients with disabilities. Services were provided by six permanent GPs, a regular locum GP and a team of nurses, which included a nurse prescriber and a nurse practitioner. A practice manager oversaw the day-to-day running of practice activities. The practice was supported by an active patient forum.

Our inspection took place on Thursday 7 August 2014 and involved two inspectors and two specialist advisors. During our inspection we spoke with the GPs and nurses employed at the practice, the practice manager, the assistant practice manager and three members of administrative and reception staff. We spoke with three patients and received comment cards from a further six patients. We also spoke with the chairperson of the patient forum.  Prior to the inspection we met with the South Gloucestershire Clinical Commissioning Group (CCG), the local Healthwatch for South Gloucestershire and NHS England. We also contacted healthcare professionals (health visitors and community nurses) who work closely with the practice. All the views expressed by patients and other healthcare professionals about the practice were very positive with a collective view that patients were at the centre of the practice’s service delivery.

We looked at how the practice met the needs of the six designated patient groups. These are: older patients, patients with long-term conditions, mothers, babies, children and young people, patients of working age and those recently retired, patients in vulnerable circumstances who may have poor access to primary care and patients experiencing a mental health problem.

We found the practice had specific provision for long-term health conditions such as clinics for patients living with diabetes, which met this need across the patient groups. We also found the practice had specific clinics for patient groups such as immunisation for meningococcal C meningitis (Men C) and septicaemia for younger adults to protect them against meningitis. The practice was aware of the needs of their practice population and had taken steps to improve or make the services more accessible for their patients. For example, the appointment system was changed in 2013 so patients were able to access same day appointments for urgent care.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to CQC at that time.