Archived: Arden Medical Centre

Updated 26 January 2017

Arden Medical Centre is located in the centre of Stratford upon Avon in Warwickshire and provides primary medical services to patients in a mainly rural area. It has a population of older patients that is slightly higher than local averages (approximately 2% above the local averages). The practice area is one of a lower than average rate of deprivation at 11% when compared with the local average of 12% and the national average of 22%.

Arden Medical Centre has two GP partners and two salaried GPs (one male and three females) who are supported by a practice manager, a practice nurse, administration and reception staff. There were 2963 patients registered with the practice at the time of the inspection.

The practice has a Personal Medical Services (PMS) contract with NHS England. The PMS contract pays GPs on the basis of meeting set quality standards and the particular needs of their local population.

Opening hours are Monday to Friday from 8.30am to 6.30pm for bookable appointments within these times and the practice is closed at weekends. Reception staff are available to take calls from 8am. Patients can wait to see a GP at the end of surgery times if no appointments are available during the day. Extended hours appointments are available on Tuesday evening from 6.30pm to 7.30pm and on a Thursday morning 7.30am to 8am each week to support patients with work commitments.

An out-of-hours service is not provided but the practice has alternative arrangements in place for patients to be seen when they are 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 and linked to the 111 service) is available on the practice’s website and in the patient practice leaflet.

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

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 and family planning.

Updated 26 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Arden Medical Centre on 19 July 2016. The overall rating for this service is good.

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

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• Information about patient safety alerts was reviewed and communicated to staff by the practice manager.
• Risks to patients were assessed and well managed through practice meetings and collaborative discussions with the multi-disciplinary team. Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• The practice was part of a local GP federation, a group of practices that worked together to provide care and share best practice to improve outcomes for patients.
• Patients told us they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice achieved results in the National GP Patient Survey published in July 2016 that were above local and national levels.
• 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 good facilities and was well equipped to treat patients and meet their needs. This included easy access for patients who used wheelchairs and baby changing facilities.
• 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.

We saw an area of outstanding practice:

• Results from the National GP Patient Survey published in July 2016 showed the practice had consistently achieved higher than local and national averages for patient feedback about the service they received and in patients’ satisfaction with how they could access care and treatment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 26 January 2017

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

• The GPs managed patients with chronic disease. Patients at risk of hospital admission were identified as a priority.
• Longer appointments and home visits were available when needed.
• All patients diagnosed with a long term condition had a named GP and were offered six monthly reviews to check that their health and medicine needs were being met.
• All GPs had their own special interests and expertise in clinical areas. Patients could book appointments to see them, for example, in diabetes, dermatology, respiratory conditions and heart disease.
• Clinical staff had close working relationships with external health professionals to ensure patients received up to date and joined up care.
• NHS health checks were offered for early identification of chronic disease and proactive monitoring.
• In-house 24 hour blood pressure monitoring, spirometry (lung function testing) and smoking cessation clinics were available.
• Patients were signposted to the practice website which had links to other patient information websites.

Updated 26 January 2017

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

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk of abuse.
• Childhood immunisation rates were mostly above the local averages. (14 out of 18 results).
• There were post-natal checks provided for mothers. The six weekly check was carried out by the GP and the nurse to enable an emotional assessment and discussion about contraception and immunisations.
• Patients told us that children and young patients were treated in an age-appropriate way and were recognised as individuals, and we saw evidence that confirmed this.
• Appointments were available outside of school hours and the premises were suitable and accessible for children.
• The practice offered a blood sample taking service for children.
• We saw good examples of joint working with midwives, health visitors, and district nurses and a midwife led clinic was provided at Arden Medical Centre.
• The practice also offered a number of online services including booking appointments and requesting repeat medicines.
• Contraception services were available at the practice.

Updated 26 January 2017

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

• The practice offered personalised care to meet the needs of the older patients in its population. It was responsive to the needs of older patients, offered home visits and rapid access appointments for those patients with enhanced needs.
• The GPs offered to do blood tests during appointments if the patient was very frail rather than sending them to the local hospital for this service.
• All staff had received training on the Mental Capacity Act and the Deprivation of Liberty guidance.
• Nationally reported data showed that outcomes for patients were good for conditions commonly found in older patients.
• The practice offered a range of enhanced services, for example, in dementia and end of life care.
• The practice engaged with an external company to provide support to patients who were over 75 years. A care coordinator worked at the practice and provided support for these patients.

Updated 26 January 2017

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 nurse had oversight for the management of a number of clinical areas, including immunisations and cervical cytology.
• The practice provided extended hour appointments on a Tuesday evening from 6.30pm to 7.30pm and on a Thursday morning 7.30am to 8am each week to support patients with work commitments.
• Health promotion advice was offered and there was accessible health promotion material available at the practice and on their website.
• The practice used the E-Referral system (formerly Choose and Book) to allow patients to choose the location and timings of their secondary care appointments.

Updated 26 January 2017

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.
• Staff were trained to recognise patients presenting with mental health conditions and to carry out comprehensive assessments.
• The practice had advised patients experiencing poor mental health how to access various support groups and voluntary organisations.
• Nationally reported data showed that outcomes for patients were good for conditions commonly found for patients with poor mental health.
• One of the GPs was a Trustee at Springfield Mind, a registered charity based in Warwickshire. The charity supported people across Warwickshire who were experiencing or recovering from long term and enduring mental health conditions.

Updated 26 January 2017

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

• The practice held a register of patients living in vulnerable circumstances including nine patients with a learning disability. The practice offered longer appointments for patients with a learning disability and had carried out annual health checks for all of the nine patients on their register at the time of the inspection.
• Clinical staff regularly worked with multidisciplinary teams in the case management of vulnerable patients. Alerts were placed on these patients’ records so that staff were aware they might need to be prioritised for appointments and offered additional attention such as longer appointments.
• Staff had been trained to recognise signs of abuse in vulnerable adults and children and the action they should take if they had concerns.