Dr JK Marsden's Practice Also known as Woodland Avenue Practice

Updated 3 June 2016

Dr J K Marsden’s Practice, also known as Woodland Avenue Practice, provides a range of primary medical services to the residents of Luton. The practice was established in 1929 at its current location of 30 Woodland Avenue, Luton, LU3 1RW.

The practice population is ethnically diverse and covers all ages with a slightly higher than average number of patients under 19 years of age. National data indicates the area is one of mid deprivation. The practice has approximately 12,000 patients with services provided under a primary medical services (PMS) contract. The practice will be moving to a general medical services (GMS) contract with effect from April 2016; a contract agreed nationally.

There are five GP partners; three male and two female and they employ three salaried GPs. The nursing team consists of three practice nurses and a health care assistant, all female. There are also a number of reception and administrative staff led by a practice manager and deputy practice manager.

The practice is a teaching and training practice and they currently have a post graduate doctor gaining experience in general practice. They provide teaching for medical students and training for nurses undertaking prescribing courses within the locality.

The practice is open from 8am to 6.30pm Monday to Friday and offers extended opening hours from 7am on Wednesdays, Thursdays and Fridays and until 8pm on Tuesdays and Wednesdays. They also open two Saturdays a month for pre-bookable appointments.

When the practice is closed out of hours services are provided by Care UK and can be accessed via the NHS 111 service.

Updated 3 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr J K Marsden’s Practice on 8 March 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 the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with dignity and respect and they were involved in their care and decisions about their treatment. Staff were described as helpful and supportive.
• Information about services and how to complain was available and easy to understand.
• Patients informed us that they were able to get appointments when they needed them but they sometimes had to wait up to two to three weeks to see a GP of choice.
• Urgent appointments were available on the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs. They had plans in place to improve access to the building.
• 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 practice was a teaching and training practice and they currently have a post graduate doctor gaining experience in general practice. They provide teaching for medical students and training for nurses undertaking prescribing courses within the locality.

We saw one area of outstanding practice:

• The practice provided many areas of support to patients whose circumstances made them vulnerable.These included renaming the waiting areas to make it easier for patients with learning disabilities to identify where they should wait for their appointment. They had developed a number of leaflets in an easy to read format using pictures and simple language to explain various tests and investigations. They had an autistic support group for patients on the autism spectrum to meet twice a year to share ideas and experiences. The meetings were attended by Autism Bedfordshire, a local group who gave advice on support services available. All staff within the practice had received autism awareness training.

The areas where the provider should make improvements are:

• Keep documented evidence of infection control audits.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 June 2016

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

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Performance for diabetes related indicators was comparable to the CCG and national average. The practice achieved 88% of available points compared to the CCG average of 85% and the national average of 89%.

• A diabetes support dietician attended the practice every month.

• Longer appointments and home visits were available when needed.

• Patients with a long term condition had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 3 June 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 had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• A screen was available for nursing mothers to use to breastfeed in private.

• We saw positive examples of joint working with midwives and health visitors.

Updated 3 June 2016

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

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• They cared for a number of patients in care homes across Luton and kept patients registered with the practice if they moved to a care home outside of the catchment area but within a reasonable distance to ensure continuity of care.

Updated 3 June 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.

• Extended hours appointments were available outside of normal working hours. Appointments were available for patients to have blood tests taken from 7am twice a week.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

• Telephone consultations were available for patients who could not attend the practice.

Updated 3 June 2016

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

• 86% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average.

• Performance for mental health related indicators was above the CCG and national average. The practice achieved 100% of available points, with 8% exception reporting, compared to the CCG average of 91% and the national average of 93%.

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

• They hosted visiting clinicians who provided support for patients. For example, a mental health worker attended weekly, an alcohol support worker attended every two weeks and a dementia support worker attended monthly.

Updated 3 June 2016

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

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• The practice had developed their own easy read leaflets to help patients, especially those with learning disabilities to understand their tests and investigations.

• They had an autistic support group for patients on the autism spectrum to meet twice a year to share ideas and experiences. Staff had received autism awareness training.

• The practice was part of a local pilot scheme to improve outcomes for socially isolated patients. Patients were supported to connect with activities to improve their physical and mental wellbeing.

• The waiting rooms in the practice were renamed to make it easier for patients with learning disabilities to identify where they should wait.

• Staff knew how 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 in normal working hours and out of hours.