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Windrush Medical Practice, Windrush Health Centre Outstanding

Reports


Review carried out on 27 June 2019

During an annual regulatory review

We reviewed the information available to us about Windrush Medical Practice, Windrush Health Centre on 27 June 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.

Inspection carried out on 5 May 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Windrush Medical Practice on 5 May 2016. Overall the practice is rated as outstanding. Specifically it is rated outstanding for the provision of safe, effective and well led services and good for the provision of caring and responsive services.

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

  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.

  • The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, using e-mails and photographs to communicate with specialists at the local hospital to reduce the need for patients to travel to outpatient clinics.

  • Feedback from patients about their care was consistently positive.

  • The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they met patients’ needs. For example by providing a floor within the practice for visiting services such as audiology and orthopaedic clinics. They also hosted the ‘hub’ which provided an overflow facility for urgent GP and nurse appointments when practices in West Oxfordshire had filled their appointments.

  • The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group. For example a new telephone system had been installed and staff rosters amended to make more staff available to answer patient calls at peak times.
  • The practice had modern and well maintained facilities and was well equipped to treat patients and meet their needs.
  • The practice actively reviewed complaints and how they were managed and responded to, and made improvements as a result.
  • The practice had a clear vision which had quality and safety as top priorities. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
  • The practice had strong and visible clinical and managerial leadership and governance arrangements.
  • An innovative approach to training qualified doctors. This involved running a simulated clinic with case studies to prepare the doctors for their first clinics. GPs in training reported that this made them more prepared for their first clinics.

  • Provision of a wide range of additional visiting services including sexual health clinics, podiatry, orthopaedic clinics, audiology clinics and counselling. This assisted patients to access services locally and avoid time consuming trips to the general hospital or other health services. An urgent care hub was also located on the premises for patients who needed to see a GP or nurse when appointments were not available at their own practice.

  • The practice recognised the importance of providing services closer to the patient. When designing the medical centre additional space was provided to accommodate a growing population and additional local services.

  • An innovative approach to training qualified doctors. This involved running a simulated clinic with case studies to prepare the doctors for their first clinics. GPs in training reported that this made them more prepared for their first clinics.

  • Prompt and effective response to patient feedback. When feedback from the national patient survey identified difficulty in accessing the practice by phone the practice purchased a new telephone system, revised staff rosters to provide more staff to answer the phone and monitored call response time. Feedback from patients during inspection identified improvement in accessing the practice by phone.

We saw several areas of outstanding practice including:

  • Operation of enhanced recall systems to ensure patients did not miss important tests or treatments. For example, GPs and nurses used information from hospital departments to remind patients who required a repeat test or scan at infrequent intervals. The risk of patients missing an important test was reduced.

  • An improved and expanded prompt system to remind patients when they required tests and treatment. This was used to support patients with complex medical needs and long term medical conditions. For example, GPs were prompted to review whether a patient diagnosed with dementia required another person to act on their behalf in making decisions about care and treatment.

  • Robust arrangements for use of technology to exchange information with hospital departments. Use of both e-mail and telemedicine with a range of hospital departments in a secure transfer system. This reduced the need for some patients to visit hospital outpatients and information returned from the hospital enabled prompt follow up for the patient with their named GP.

  • Provision of a health information zone managed by the PPG. This included a computer terminal for patients to access information on local services and health promotion literature. The PPG members assessed useful information, often influenced by their discussions with other patients, to hold. They agreed what could be displayed with the practice. This information zone was for patients run by patients.Provision of services to 10 Syrian refugees and two local traveller communities. Feedback from these groups was positive. Particularly from members of the travelling community who benefitted from seeing their named GP for continuity of care. The practice record system alerted staff to book 30 minute appointments for members of the Syrian community and to book a translator who spoke the appropriate dialect.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 10 July 2014

During a routine inspection

Windrush Medical Practice is a GP practice with approximately 14,000 registered patients situated in Witney in Oxfordshire. The practice provides a range of services for patients, which include clinics to manage long term conditions, minor surgery, family planning, child health, nurse led minor illness clinics and a dispensary.

Patients we spoke with gave us positive comments about the practice and the staff. We also spoke with four GPs, three practice nurses, the practice manager, dispensary staff, administrative staff and representatives of the patient participation group (PPG). Procedures are in place to protect vulnerable patients and to monitor cleanliness and reduce the risk of infection in the practice environment. The practice provides an effective service to patients, carrying out a range of audits and supporting the professional development of staff. We received positive feedback from patients about the caring nature of practice staff. The practice responds to the needs of patients. Particular care had been taken to anticipate the needs of patients when the practice was built. The five year business plan demonstrates the commitment of the practice management to provide high quality care and promote good outcomes for patients going forward.

During our inspection we looked at how well services are provided for specific groups of people and what good care looks like for them. The population groups we reviewed were:

  • Older people
  • People with long-term conditions
  • Mothers, babies, children and young people
  • The working-age population and those recently retired
  • People in vulnerable circumstances who may have poor access to primary care
  • People experiencing mental health problems

The practice provided for the needs of older patients through always allocating named GPs for patients over 75 years of age. Patients with long term conditions were provided for by a number of clinics aimed specifically at their needs. Mothers, babies and young children receive services including child development checks and immunisation. The needs of working age patients are recognised. A range of suitable appointments are available and telephone advice could be offered. The practice met the needs of patients in vulnerable circumstances by taking consideration of the needs of people in traveling communities. Counselling was provided at the practice for patients with poor mental health.

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 the Care Quality Commission at that time.

For this inspection we visited Windrush Medical Practice, Windrush Health Centre, Welch Way, Witney Oxfordshire, OX28 6JS.

Inspection carried out on 13 June 2014

During Reference: not found