Henley-In-Arden Medical Centre

Updated 21 December 2016

Henley in Arden Medical Centre is located in the small market town of Henley in Arden, South Warwickshire and serves a practice population of approximately 6,700 patients in the town and the surrounding villages. Although the practice is geographically isolated they are active members of the South Warwickshire Clinical Commissioning Group (CCG) and the GP federation. The practice area is one of lower than average deprivation with a larger population of older people compared with the county average.

The practice has three GP partners (one male and two female) and two female salaried GPs. The GPs are supported by a practice manager, an IT manager, a head receptionist, a nurse practitioner, a practice nurse, four healthcare assistants, a cleaner, administration and reception staff.

Henley in Arden Medical Centre is an approved training practice for trainee GPs. A trainee GP is a qualified doctor who is training to become a GP through a period of working and training in a practice. There are two GP trainers and two trainee GPs at the practice.

The practice opens on Monday to Friday each week from 8am to 1pm and 2pm to 6.30pm and also from 8.25am until 11.55am on Saturday, with appointments available between these times. When the practice is closed during lunch time, cover is provided by the duty GP.

The practice does not provide an out-of-hours service but has alternative arrangements in place for patients to be seen when the practice is closed. For example, if patients call the practice when it is closed, an answerphone message gives the telephone number they should ring depending on the circumstances. Information on the out-of-hours service (provided by Care UK) is available on the practice’s website and in the patient practice leaflet.

Home visits are available for patients who are housebound or too ill to attend the practice for appointments. There is also an online service which allows patients to order repeat prescriptions, book and cancel appointments and to view medical records.

The practice has a General Medical Services (GMS) contract with NHS England. The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities. The practice also provides minor surgery.

The practice treats patients of all ages and provides a range of medical services. This includes disease management such as asthma, diabetes and heart disease. Other appointments are available for maternity care, physiotherapy and mental health services.

Updated 21 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Henley-In-Arden Medical Centre on 8 September 2016. The overall rating for this service is good.

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

• Processes and procedures were in place to keep patients safe. This included a system for reporting and recording significant events, keeping these under review and sharing learning where this occurred.

• The practice was aware of and provided services according to the needs of their patient population.

• Staff received regular training and skill updates to ensure they had the appropriate skills, knowledge and experience to deliver effective care and treatment.

• Regular meetings and discussions were held with staff and multi-disciplinary teams to ensure patients received the best care and treatment in a coordinated way.

• Patients told us they were treated with dignity and respect and that they were fully involved in decisions about their care and treatment.

• Information about services and how to complain was available and easy to understand. Patients told us that they knew how to complain if they needed to.

• The practice had an active Patient Participation Group (PPG). The PPG were proactive in representing patients and assisting the practice in making improvements to the services provided.

• There was a clear leadership structure and staff told us they felt supported by management. The practice proactively sought feedback from patients, which it acted on. Staff appeared motivated to deliver high standards of care and there was evidence of team working throughout the practice.
• The practice was aware of the requirements of the duty of candour and systems were in place to ensure compliance with this. There was a culture of openness and accountability.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 December 2016

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

• The practice nurses had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Nursing staff had received appropriate training in chronic disease management, such as asthma and diabetes.
• Longer appointments and home visits were available when needed.
• All patients diagnosed with a long term condition had a named GP and a structured annual review to check that their health and medicine needs were being met.
• Clinical staff had close working relationships with external health professionals to ensure patients received up to date care.
• NHS health checks were offered for early identification of chronic disease and proactive monitoring.
• Patients were signposted to the practice website which provided links to other information websites.

Updated 21 December 2016

The practice is rated as good for the care of families, children and young people.

• Same day appointments were offered to all children under the age of five who needed to be seen urgently.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• Childhood immunisation rates for the vaccinations given were comparable to local and national averages.
• The practice offered a number of online services including requesting repeat medicines and booking appointments.
• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were considered to be at risk of harm. For example, children and young people who had a high number of accident and emergency attendances.
• The practice’s uptake for the cervical screening programme was 81% which was comparable to the local and national averages of 83% and 82% respectively.
• The practice worked with midwives and health visitors to coordinate care.

Updated 21 December 2016

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

• The practice offered personalised care to meet the needs of the older people in its population. It was responsive to the needs of older patients. They offered home visits and rapid access appointments for those patients with enhanced needs.
• The practice offered a range of enhanced services, for example, in dementia and end of life care.
• Nationally reported data showed that outcomes for patients were good for conditions commonly found in older patients.
• A practice nurse co-ordinated the care for elderly patients and liaised with Age UK in the over 75s project.
• The practice provided weekly ward rounds at a local nursing home to ensure continuity of care for those patients.

Updated 21 December 2016

The practice is rated as good for the care of working-age patients (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 as well as a full range of health promotion and screening services that reflected the needs of this age group.
• The practice nurses had oversight for the management of a number of clinical areas, including immunisations, cervical cytology and some long term conditions.
• Health promotion advice was offered such as smoking cessation and nutrition, with health promotion material available at the practice and on its website.
• Extended hours appointments were available from 8.25am until 11.55am on Saturday mornings for easier access for those patients who were unable to attend appointments during daytime hours.

Updated 21 December 2016

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

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. It carried out advanced care planning and annual health checks for patients with dementia and poor mental health.
• The practice had advised patients experiencing poor mental health how to access various support groups and voluntary organisations. It had a system in place to follow up patients who had attended accident and emergency departments where they may have been experiencing poor mental health.
• Nationally reported data showed that outcomes for patients were good for conditions commonly found for patients with poor mental health.
• Clinical staff were trained to recognise patients presenting with mental health conditions and to carry out comprehensive assessments.

Updated 21 December 2016

The practice is rated as good for the care of patients whose circumstances may make them vulnerable.

• Staff had been trained to recognise signs of abuse in vulnerable adults and children and the action they should take if they had concerns. There were lead members of staff for safeguarding, and GPs were trained to an appropriate level in safeguarding adults and children. All safeguarding concerns were discussed at the weekly GPs meetings.
• All staff had completed Identification and Referral to Improve Safety (IRIS) training in domestic violence. Arrangements were in place to support patients where needed.
• The practice held a register of patients living in vulnerable circumstances including those patients with a learning disability.
• Longer appointments were available for patients with a learning disability. The practice had carried out annual health checks for 60% of the patients on their register (10) so far this year.
• Clinical staff regularly worked with multidisciplinary teams in the case management of vulnerable patients. Alerts were added to patients records for staff awareness so that longer appointments could be allocated.
• It was the practice’s policy to register and treat people from vulnerable group such as travellers and those people who were homeless.