Archived: Lawley Medical Practice

Updated 27 June 2016

Lawley Medical Practice was established in April 1999. It moved into purpose built premises in Telford in February 2002. The practice holds a Personal Medical Services (PMS) contract with NHS England. A PMS contract is a locally agreed alternative to the standard General Medical Services (GMS) contract used when services are agreed locally with a practice which may include additional services beyond the standard contract.

The practice area has average deprivation when compared with the national and local Clinical Commissioning Group (CCG) area. At the time of our inspection the practice had 8466 patients. The practice age distribution is higher than the national and CCG average for 0-14 year olds. It has a lower than national average of patients aged 55 and above but was comparable with the local CCG for this age range. The practice is a training practice for GP registrars to gain experience and higher qualifications in general practice and family medicine.

The practice staffing comprises of three GP partners (two male and one female), one salaried GP (female), one advance nurse practitioner, three practice nurses, a practice manager, an office manager, and a team of administrative / reception staff working a range of hours.

The practice is open every week day from 8am until 6pm, except between 12.30pm and 2pm on Wednesdays, when the practice is closed for staff training. Consultation times vary depending on which GP is working, the earliest at 8.30am and the latest at 5.10pm. Extended hours appointments are available with the GPs, the advanced nurse practitioner and nurses on Monday evenings.

The practice is also part of a network of GP Practice offering extended opening hours for routine appointments. The practice offers routine appointments on a Tuesday evening for patients registered at any of the practices in the network.

The practice has opted out of providing cover to patients in the out-of-hours period. During this time services are provided by Shropdoc, patients access this service by calling 0333 222 66 55.

Updated 27 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Lawley Medical Practice on 24 February 2016. A breach of legal requirement was found and a requirement notice was served. After the comprehensive inspection the practice sent us an action plan to say what they would do to meet legal requirements in relation to:

• Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Fit and proper persons employed.

We undertook a focused inspection on 15 June 2016. We did not visit the practice but reviewed information sent to us by the provider. The inspection was to check that the practice had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Lawley Medical Practice on our website at www.cqc.org.uk.

Our key findings were as follows:

• Disclosure and Barring Service (DBS) checks had been obtained for all clinical staff who worked at the practice and acted as chaperones.
• The DBS check protocol had been reviewed and amended to include a clear timeline for new staff to bring in appropriate documentation, and the subsequent consequences of not doing so.
• The practice had introduced a ‘Safer Recruitment Self-Declaration Form’ as a condition of employment.

Overall the practice is rated as good and good in the safe domain. This recognises the improvements made to the quality of care provided by this service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 May 2016

The practice was 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 and patients with complex needs (referred to as priority patients) were identified as a priority.
• The practice maintained registers of patients with long term conditions. Patients were offered a structured annual review to check their health and medicines needs were being met.
• Performance for the five diabetes related indicators was better than the national average. For example: The percentage of patients with diabetes, on the register, in whom a specific blood test was recorded was 90% compared with the national average of 78%.
• 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.
• Care plans were developed for patients with diabetes, asthma and chronic lung conditions.

Updated 24 May 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 who were at risk, for example families with children in need or on children protection plans.
• Appointments were available outside of school hours and the premises were suitable for children and babies. Same day emergency appointments were available for children.
• There were screening and vaccination programmes in place and the practice’s immunisation rates
• Data from the Quality and Outcomes Framework (QOF) for 2014/2015 showed that 87% of women aged 25-64 had received a cervical screening test in the preceding five years. This was above the national average of 82%.
• The practice ran a Women’s Health Clinic one afternoon / evening a week. Services included family planning and contraception services including implant/coil fitting, as well as support with menopausal and continence issues. Chlamydia screening was available in the practice.
• We saw positive examples of joint working with midwives and health visitors. Midwife and health visitor clinics were held at the practice.

Updated 24 May 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.
• Patients had access to a care co-ordinator, who provided support with accessing services and benefits.
• The practice identified if patients were also carers.

Updated 24 May 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 hours one evening a week, as well as telephone consultation and triage.
• 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 24 May 2016

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

• QOF data from 2014/2015 showed that 90% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months. This was comparable with the national average of 84%.
• QOF data from 2014/2015 showed that 94% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in their record, in the preceding 12 months. This was comparable with the national average of 88%.
• The practice held registers of patients with poor mental health and dementia. Patients experiencing poor mental health were offered an annual physical health check.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• Counselling services were available at the practice.

Updated 24 May 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 living in vulnerable circumstances including travellers and those with a learning disability.
• Longer appointments were available for patients with a learning disability.
• Patients requiring additional assistance were identified on the electronic patient record, for example, patients with a visual impairment or hearing loss.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients (known as priority patients).
• 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.