What is the Quality of Care at Concord Medical Centre

Positive

"The practice offered proactive personalised care to meet the needs of the older patients in its population and was responsive to the needs of patients who were living with dementia or were receiving end of life care."

Positive

"Staff received training about how to care for patients with mental health needs and dementia ensuring patients remained calm when visiting the practice."

Positive

"People experiencing poor mental health including people with dementia The practice is rated as outstanding for the care of patients experiencing poor mental health including patients with dementia."

Positive

"There were many aspects to their role including being a dementia friend."

Positive

"One of the GPs had a lead role as a dementia champion and had involvement with the local dementia group."

Neutral

"GPs had received dementia awareness training through the Clinical Commissioning Group."

Neutral

"We were told the practice had a protocol for assessment for dementia before they were referred to a memory service for further diagnosis."

Neutral

"Examples of long term conditions are diabetes dementia CVD musculoskeletal conditions and COPD this list is not exhaustive."

Positive

"Patients with a learning disability and patients with a mental health needs had care plans in place to ensure their needs were assessed and care was planned to ensure the best outcomes for patients."

Positive

"Staff received training about how to care for patients with mental health needs and dementia ensuring patients remained calm when visiting the practice."

Positive

"Discussions with staff showed the practice worked in partnership with other health and social care providers such as social services local mental health teams and district nursing services to meet patients’ needs in an effective way."

Positive

"The practice also had lead roles for all clinical care areas such as epilepsy atrial fibrillation mental health and palliative care."

Positive

"People experiencing poor mental health including people with dementia The practice is rated as outstanding for the care of patients experiencing poor mental health including patients with dementia."

Positive

"The practice regularly worked with multidisciplinary teams in the case management of patients experiencing poor mental health including those with dementia."

Positive

"The mental health nurse Are services effective?"

Positive

"We saw many areas where the practice had led innovative service redesign; the use of the DEXA scanner the ENT service the use of Dermatoscopy employing a mental health nurse consultant and integrated service with the Bristol Oncology Centre."

Positive

"The mental health nurse consultant also had an important role in working closely with health visitors and GPs to help prevent families from reaching crisis point and needing intervention."

Positive

"The practice mental health consultant also attended so they could be involved to help prevent or mitigate the risk of a situation deteriorating and sharing information of relevance with those who were appropriate."

Neutral

"They had also recruited a mental health nurse consultant following a review of their patient needs."

Neutral

"The practice informed patients experiencing poor mental health about how to access various support groups and voluntary organisations including MIND."

Neutral

"The practice has also employed a mental health nurse consultant to oversee patients with mental health conditions to provide assessment monitoring and treatment to those who needed it."

Neutral

"This had changed practice in many areas including the recruitment of a fulltime mental health nurse consultant."

Neutral

"They reviewed attendances for specific patient groups and found mental health had high attendance."

Neutral

"They had specialism areas in obstetrics gynaecology child health mental health minor surgery and dermatology."

Positive

"One of the GP partners we spoke with told us they had identified the additional external support from a GP with a specialist interest in mental health to offer professional support and develop expertise amongst the partnership."

Positive

"There were monthly meetings with a multidisciplinary team consisting of community district nurses the practice mental health nurse consultant and the palliative care team to discuss and meet the needs of patients with complex health care needs."

Positive

"The practice held multidisciplinary monthly meetings with other health care professionals such as district nurses mental health nurse consultant palliative care nurses health visitors and midwifes."

Positive

"Patients had benefitted because the practice had employed a specialist in mental health nurse consultant as this provided more consistent care and treatment."

Positive

"In addition the practice had a mental health nurse consultant who supported patients experiencing mental health issues."

Positive

"The practice was involved in various multidisciplinary monthly meetings which involved palliative care nurses health visitors mental health nurse and district nurses."

Positive

"The mental health nurse consultant employed by the practice supported new mothers who were diagnosed with postnatal depression."

Positive

"The practice employed a full time mental health nurse consultant to see patients when they needed additional mental health support."

Positive

"The mental health nurse provided support for patients who were waiting for their appointment in specialist services."

Neutral

"Additional services included scanning for osteoporosis ear nose and throat ENT procedures including mircosuction specifically for cleaning of the ears and a full time mental health nurse consultant."

Neutral

"Patients experiencing poor mental health had access to a practice mental health nurse consultant who provided additional therapies and support."

Neutral

"People experiencing poor mental health The practice had recognised the need to support patients with mental health needs."

Neutral

"They employed a fulltime mental health nurse consultant who worked closely with patients and the GP team."

Neutral

"They provided essential support to patients with a diagnosed mental health problem."

Neutral

"The practice employed a fulltime mental health nurse consultant."

Neutral

"With qualifications in cognitive behaviour therapy psychiatric nursing and community mental health nursing."

Neutral

"The mental health nurse had regular meetings with the lead GP to avoid professional isolation and to share patient information."

Positive

"Future awareness evenings were planned for depression chronic illness respiratory and diabetes."

Positive

"For example the practice had completed audits for patients with cholesterol diabetes coeliac disease leg ulcers postnatal depression and deep vein thrombosis."

Positive

"This may range from depression including post natal depression to severe mental illnesses such as schizophrenia."

Positive

"Patients with a learning disability and patients with a mental health needs had care plans in place to ensure their needs were assessed and care was planned to ensure the best outcomes for patients."

Positive

"The practice had a system which ensured patients with a learning disability were identified and received an annual health check."

Positive

"Patients with a learning disability were asked to attend an annual health check in line with national enhanced service guidelines."

Positive

"Patients with a learning disability benefited from an annual health check by the practice nurses."

Neutral

"The practice had patients registered from a local learning disability care home."

Positive

"The practice nurse told us diabetes asthma and chronic obstructive pulmonary disease COPD had personalised care plans and were provided with appropriate supporting information."

Positive

"Chronic disease clinics were available with the nurse and GP for conditions such as asthma chronic obstructive pulmonary disease COPD and stroke."

Positive

"One of the nurses also told us about the diploma they had achieved in asthma and the benefits this had produced for patients."

Neutral

"For example the chart informed staff who could see patients for annual diabetes or asthma checks or for immunisations."

Positive

"Our findings All patients who were diagnosed with a long term health condition such as asthma chronic obstructive pulmonary disease COPD and diabetes had an alert flagged on the computer system and were allocated a named GP for consistency."

Positive

"For example each treatment the nursing staff provided there was an additional member who was also trained in it such as asthma or chronic obstructive pulmonary disease COPD checks."

Positive

"• The practice had developed an integrated service provision with the Bristol Oncology Centre hospital staff to provide in house oncology treatment a branch of medicine which deals with cancer for their own patients and patients from other practices within the community."

Positive

"This service provides a faster access to accurate diagnosis for patients; it also promotes greater awareness of skin cancer amongst the GPs carrying out the procedure and has reduced unnecessary hospital referrals."

Positive

"The practice had developed an integrated service provision with the Bristol Oncology Centre hospital staff to provide inhouse oncology treatment a branch of medicine which deals with cancer for their own patients and patients from other practices within the community."

Positive

"The practice had developed an integrated service provision with the Bristol Oncology Centre hospital staff to provide in house oncology treatment a branch of medicine which deals with cancer for patients within the community."

Positive

"The practice nurse told us diabetes asthma and chronic obstructive pulmonary disease COPD had personalised care plans and were provided with appropriate supporting information."

Positive

"Routine checks associated with diabetes care were undertaken and where diagnosis indicated referrals for dietary services and annual eye screening were made."

Positive

"For example the practice had completed audits for patients with cholesterol diabetes coeliac disease leg ulcers postnatal depression and deep vein thrombosis."

Neutral

"Specialist clinics were in place to review patients with long term conditions this included for example a diabetes clinic with a GP and the practice nurse."

Neutral

"One of the aims of the clinic was to give patients living with diabetes the information needed to manage their condition."

Neutral

"They also checked that all routine health checks were completed for longterm conditions such as diabetes and that the latest prescribing guidance was being used."

Neutral

"Nursing staff had attended training courses about respiratory diseases and diabetes in order to maintain and increase their skills and knowledge in those areas."

Neutral

"For example the chart informed staff who could see patients for annual diabetes or asthma checks or for immunisations."

Positive

"Our findings All patients who were diagnosed with a long term health condition such as asthma chronic obstructive pulmonary disease COPD and diabetes had an alert flagged on the computer system and were allocated a named GP for consistency."

Positive

"This was held to provide an open forum and discussion about diabetes and raised patient awareness about how to better manage their diagnosed condition."

Neutral

"The practice offered a range of clinics during the week run by specially trained nurses for patients with long term health conditions such as diabetes and respiratory conditions."

Neutral

"Examples of long term conditions are diabetes dementia CVD musculoskeletal conditions and COPD this list is not exhaustive."

Neutral

"Patients were able to see two nurses who specialised in diabetes and respiratory conditions."

Neutral

"One of the practice nurses had run a diabetes awareness evening approximately six months ago."

Positive

"The practice also had lead roles for all clinical care areas such as epilepsy atrial fibrillation mental health and palliative care."

Positive

"For example prescribing protocols were revised when new guidance was produced for antibiotic use for patients with renal impairment."

Positive

"Patients with a learning disability and patients with a mental health needs had care plans in place to ensure their needs were assessed and care was planned to ensure the best outcomes for patients."

Positive

"The practice had a system which ensured patients with a learning disability were identified and received an annual health check."

Positive

"Patients with a learning disability were asked to attend an annual health check in line with national enhanced service guidelines."

Positive

"Patients with a learning disability benefited from an annual health check by the practice nurses."

Neutral

"The practice was adapted to support older patients who were frail or who had a disability to visit the practice."

Neutral

"The practice had patients registered from a local learning disability care home."

Positive

"The practice offered a full range of immunisations for children travel vaccines and flu vaccinations in line with current national guidance."

Positive

"We saw fire extinguishers blood pressure monitors electrocardiogram ECG and weighing scales had been recently tested and the weighing scales were due to be checked in the week we inspected."

Positive

"The practice nurse told us equipment such as ECG machines blood pressure monitors spirometry and weighting machines were calibrated every six months."

Positive

"This service provides a faster access to accurate diagnosis for patients; it also promotes greater awareness of skin cancer amongst the GPs carrying out the procedure and has reduced unnecessary hospital referrals."

Neutral

"One GP told us they were completing a deep vein thrombosis DVT audit."

Positive

"Patients were also offered any outstanding health checks required and offered additional vaccines such as shingles and the pneumococcal vaccine."