Winshill Medical Centre

Updated 9 December 2016

Winshill Medical Centre is registered with the Care Quality Commission (CQC) as a two GP partnership. The practice is located in Burton-on-Trent. The practice has good transport links for patients travelling by public transport and parking facilities are available for patients travelling by car. The practice is situated within a single storey building containing three consulting rooms and three treatment rooms. There is level access to the building and doors to the building are automated. All areas within the practice are accessible by patients who use a wheelchair or parents with a pushchair.

The practice team consists of two GP partners, one male, one female. The GP partners are supported by a sessional GP who works one day each week, two practice nurses, a pharmacist and a healthcare assistant. Clinical staff are supported by a practice manager, two medical secretaries and four administration/reception staff. In total there are 13 staff employed either full or part time hours to meet the needs of patients. The practice also uses a regular GP locum to support the clinicians and meet the needs of patients at the practice.

The practice is open every week day between 8am and 6.30pm. Appointments are available from 8am to midday and from 2pm to 6.20pm in. Extended hours are offered on alternate days each week when the practice remains open until 7.15pm. The practice does not provide an out-of-hours service to its patients but has alternative arrangements for patients to be seen when the practice is closed. Patients are directed to the out of hours service, provided by Staffordshire Doctors Urgent Care, via the NHS 111 service.

The practice has a Primary Medical Services contract with NHS England to provide medical services to approximately 3903 patients. It provides Directed Enhanced Services, such as the childhood immunisations, minor surgery and asthma and diabetic reviews. The practice has a higher proportion of patients aged under 18 (28.5% compared to the England average of 20.7%) and a lower proportion of patients aged 65 and over when compared to the practice average across England (11.9% compared to the England average of 17.1%). The income deprivation affecting children of 26% was higher than the national average of 20%. The level of income deprivation affecting older people was the same as the national average (16%).

A library service and a physiotherapy service operated from the building.

Updated 9 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Winshill Medical Centre on 31 August 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 a system in place for reporting and recording significant events.
• Staff understood their responsibilities to raise concerns and to report incidents and near misses. The practice had a formal system in place for the ongoing monitoring of significant events, incidents and accidents.
• Some arrangements were in place to ensure that risks to patients were assessed and managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• The practice had a programme of continuous clinical and internal audit in order to monitor quality and make improvements.
• The practice invested in staff development and training.
• 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 the 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.

There were areas of practice where the provider should make improvements:

• Explore how the practice could proactively identify more patients who also acted as carers.

• Consider audits to ensure that nationally recognised guidelines for clinical care are being followed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 9 December 2016

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

• The practice nurse had a lead role in chronic disease management and patients at risk of hospital admission were identified as a priority.
• The practice Quality and Outcomes Framework (QOF) for the care of patients with long-term conditions was similar to or higher than the local and national average. For example the practice performance for diabetes related clinical indicators was higher than the local Clinical Commissioning Group and England average (92% compared to the local average of 91% and England average of 89%).
• Longer appointments were available when needed and home visits made to patients who were housebound.
• The named GP and practice nurse worked with relevant healthcare professionals to deliver a multidisciplinary package of care to patients with complex needs.
• All newly diagnosed diabetic patients and patients with poorly controlled diabetes were referred to the DESMOND service, a service that provides a diabetic education programme.

Updated 9 December 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 did not attend hospital appointments.
• Immunisation uptake rates for standard childhood immunisations were similar to the local CCG and national averages. For example, childhood immunisation rates for the vaccination of children under two years of age ranged from 94% to 96%, children aged two to five 86% to 97% and five year olds from 84% to 93%.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals. Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice offered contraceptive services and the nurse provided condoms to patients and chlamydia testing kits.
• The practice’s uptake for the cervical screening programme was 81%, which was comparable to the national average of 82%.
• All pregnant patients were contacted to provide prescriptions for folic acid.

Updated 9 December 2016

The practice is rated as good for the care of older people.

• The practice offered personalised care to meet the needs of the older people in its population.
• The practice offered GP and pharmacist (to complete medication reviews) home visits to older people who were housebound only.
• Flexible appointments were available for older patients.
• All patients aged 65 and over were offered a health check including blood tests.
• A GP was recruited in 2014 to provide a weekly ward round to one nursing home and one care home housing elderly patients. This had resulted in a reduction in the A&E attendances from patients in these homes. For example, the figures for the corresponding year to date showed that A&E attendances had reduced from five attendances in 2014/15 to one attendance in 2015/16 and no attendances in 2016/17.
• Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people.

Updated 9 December 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 offered extended opening hours and the appointment telephone line was easily accessible to patients who worked during the day.
• 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 9 December 2016

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

• The practice regularly worked with multi-disciplinary teams in the case management of people who experienced poor mental health, including those with dementia.
• The practice held a register of patients who experienced poor mental health. Clinical data for the year 2016/17 showed that 25 of 42 patients on the practice register who experienced poor mental health had a comprehensive agreed care plan. The provider had planned to complete the remaining 17 care plans before April 2017.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. For example, the community mental health team.
• The percentage of patients diagnosed with dementia, whose care had been reviewed in a face to face review in the preceding 12 months was 89%, which was higher than the national average of 84%.
• The practice maintained a register of patients diagnosed with dementia.
• The practice performed weekly ward rounds for three nursing homes that housed patients with dementia.

Updated 9 December 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 with a learning disability and had plans in place to ensure annual health checks were carried out for these patients.
• The practice had a high prevalence of young patients living in vulnerable circumstances, when identified the practice assisted and supported these patients on an individual basis.
• Staff had been trained 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.
• 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. For example the adult ability team, a service that included physiotherapy and counselling.
• Staff told us of a number of patients who were offered open access to apppointments to reduce A&E attendances. Flexible appointments were offered to patients with learning disabilities.