Abbottswood Medical Centre

Updated 24 March 2016

Drs Wunsch, Atkinson, Thomas, Evans, Embley and Baxter provide care for approximately 10,400 patients. The practice covered a number of surrounding villages. The practice holds a General Medical Services contract and provides GP services commissioned by NHS England.

The practice is managed by six GP partners (two male, four female) and there is one salaried GP who between them provide 45 clinical sessions per week. They are supported by a nurse prescriber who provides a further eight sessions a week for patients who have minor illnesses. There are six practice nurses and four nursing assistants who provide clinical services. The practice employs a practice manager, a quality officer, an administration clerk, three secretaries, two IT staff and a finance officer. The front of house manager works with a reception supervisor and nine reception staff.

Patients who live in excess of one mile from a pharmacy are eligible to have their prescribed medicines dispensed from the practice. This equates to 6,000 registered patients. Medicines can be collected from the practice or any of a number of designated outlets. The dispensary has a dispensary manager, nine dispensing staff, and administrator and two prescriptions couriers. The opening hours are 8.30am until 1pm and 2pm until 6pm each weekday.

The practice is a teaching and training practice, which supports and mentors trainee GPs. There are currently two trainee GPs working at the practice who provide 16 sessions per week.

The practice is open from 8am until 6.30pm each day. Appointments are available 8.30am until 11.45am and 3.30pm until 5.20pm each weekday. Extra appointments are available if needed. Urgent appointments are available on the day. Routine appointments can be pre-booked in advance in person, by telephone or online. Telephone advice is also available for patients who are unsure if they need an appointment and for provision of advice for children. Extended hours include Monday or Tuesday from 6.30pm until 7.20pm and Wednesdays from 7am until 7.40am. Patients can also be seen by a GP one Saturday of each month between the hours of 8am and 10.20am. All extended hours are by pre-booked appointments only.

The practice has opted out of providing GP services to patients out of hours such as nights and weekends. During these times GP services are provided currently by a service commissioned by NHS South Worcestershire Clinical Commissioning Group (CCG). When the practice is closed, there is a recorded message giving out of hours’ details. The practice leaflet also includes this information and there are leaflets in the waiting area for patients to take away with them.

Updated 24 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Drs Wunsch, Atkinson, Thomas, Evans, Embley and Baxter on 16 February 2016. Overall the practice is rated as good.

Our key findings were as follows:

• There was an open and transparent approach to safety and an effective system was in place for reporting and recording significant events. The premises were visibly clean and tidy. Checks carried out during staff recruitment served to protect patients from risks of harm.

• Systems were in place to ensure medicines were safely dispensed and vaccines were stored appropriately and in date for safe administration. However, more secure storage of medicines was needed in the dispensary.

• Patients had their needs assessed and care delivered in line with current guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment. Staff promoted health education to empower patients to live healthier lives.

• Feedback from patients and observations throughout our inspection showed that staff were kind caring and helpful.

• Practice staff worked closely with other organisations and professionals in planning how services were provided to ensure that they meet people’s needs. People with complex needs had care plans in place that were regularly reviewed.

• There was a system in place to respond to and act on feedback and complaints.

• There was a clear leadership structure and staff told us they felt supported by management. It was evident that there was a strongly motivated staff team who worked together in making on-going improvements of the services provided for patients.

However, there was an area of practice where the provider needs to make improvements.

The provider should:

• Review arrangements to prevent unauthorised entry to the dispensary.

• Review the arrangement for identifying and recording those patients who were also carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 March 2016

The practice is rated good for the care of people with long-term conditions. Nursing staff had lead roles in chronic disease management and were further developing their knowledge and skills to provide clinical support for GPs. Longer appointments were available when patients were seen to ensure they received comprehensive reviews. Where necessary these patients had a personalised care plan in place and were regularly monitored to check that their health and care needs were being met.

Updated 24 March 2016

The practice is rated good for the care of families, children and young people. There were systems in place to follow up on children who were considered to be at risk. A health visitor was invited to the regular multidisciplinary meetings to discuss any safeguarding issues as well as those children who had long term conditions. Patients we spoke with told us that children and young adults were treated in an age appropriate way and were recognised as individuals. Children were given same day appointments. Out of school appointments were available through extended hours. On either Mondays or Tuesdays evening appointments were available until 7.20pm and every Wednesday from 7am. Weekend appointments were available one Saturday per month from 8am until 10.20am.

Updated 24 March 2016

The practice is rated good for the care of older people. There was a higher than average number of older patients registered at the practice. For example, both male and female patients aged 65 to 69 years constituted 9% of the practice population compared with 6% nationally.  Clinical staff offered proactive, personalised care and the enhanced services included prevention of unnecessary hospital admissions. Home visits were carried out and urgent appointments given to those patients who had complex needs. Staff had regular contact with district nurses and other professionals in meetings to discuss any concerns or changes that were needed to patient care. The Proactive Care Team (PACT) carried out assessments and prescribed medicines for minor ailments for patients who lived in rural locations and care home. PACT staff attended the multidisciplinary meetings and liaised closely with GPs for the timely delivery of care needs.

Updated 24 March 2016

The practice is rated good for the care of working-age people (including those recently retired and students). All eligible patients who had attended the practice had received contraceptive advice and procedures and cervical screening. Extended opening hours assisted this population group in attending appointments and telephone consultations could be booked up to two weeks in advance. Online services were available for booking appointments and ordering repeat prescriptions. The practice website gave advice to patients about how to treat minor ailments without the need to be seen by a GP or the nurse practitioner.

Updated 24 March 2016

The practice is rated good for the care of people experiencing poor mental health (including people with dementia). Staff were trained to recognise metal health presentations and carry out comprehensive assessments. Practice staff regularly worked with multidisciplinary teams in the case management of patients who experienced poor mental health. Clinical staff carried out assessments for early diagnosis of dementia. Patients who had dementia and those who experienced mental health illness were discussed during clinical multidisciplinary meetings and care plans were developed. Referral mechanisms were in place for when staff identified deterioration in patient’s mental health.

Updated 24 March 2016

The practice is rated good 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. Annual health checks for all people with a learning disability were carried out and health action plans updated. Clinical staff worked with other agencies and professionals in the case management of vulnerable patients. Longer appointments were offered to patients who had a learning disability.