Whitehall Medical Practice

Updated 7 February 2017

Whitehall Medical Practice is a GP practice which provides primary medical services under a General Medical Services (GMS) contract to a population of approximately 13,500 patients living in Hillmorton and surrounding areas of Rugby. A GMS contract is a standard nationally agreed contract used for general medical services providers.

The practice operates from a spacious two-storey building where consultations with patients take place on both levels. There is a lift available to allow access to the first floor for patients with mobility problems.

The practice population has a higher than average number of patients aged 10-20 years, 45–50 years and 60–80 years. National data indicates that the area is one that does not experience high levels of deprivation. The practice population is made up of predominantly white British with pockets of patients from ethnic minority groups.

There are four GP partners, two female and two male. The practice also employ a salaried female GP, a nurse practitioner, four practice nurses, a practice manager and reception manager, who are supported by a team of administrative and reception staff.

Whitehall Medical Practice is an approved training practice for trainee GPs and supports medical students training to be doctors. A trainee GP is a qualified doctor who is training to become a GP through a period of working and training in a practice.

The practice is open on Monday until Friday between 8am and 6pm, and offers extended hours appointments, which are provided from 6.30pm until 10pm on Mondays by pre-bookable appointments only. The practice provides a triage service daily with a dedicated duty GP from 8am until 6.30pm. Between the hours of 6pm and 6.30pm calls are taken by the out of hours provider through a local agreement. When the surgery is closed, services are provided by the local out of hours service who can be contacted via NHS 111.

Updated 7 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Whitehall Medical Practice on 8 November 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 were trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. We noted that the number of carers on the carers register was less than expected and the practice were taking action to address this.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had suitable facilities and was well equipped to treat patients and meet their needs.
• 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 areas where the provider should make improvement are:

• Continue to explore ways of increasing the numbers of carers identified.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 7 February 2017

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.
• The percentage of patients with diabetes who had a blood glucose level within the acceptable recommended range was 70%, which was comparable to the CCG and national average of 71% and 70% respectively.
• Longer appointments and home visits were available when needed.
• All these patients 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 7 February 2017

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 who had not attended for immunisation or health checks. Immunisation rates were high for all standard childhood immunisations.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• Cervical screening rates were 82%, which was comparable with the CCG and the national average of 81%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 7 February 2017

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. The practice participated in the local incentive scheme for care homes and provided services to 18 local care homes with an allocated named GP for each one.
• Weekly visits were provided to the larger care homes and we saw positive feedback regarding the service provided.
• Housebound patients were visited at home to provide the flu vaccinations and we saw positive feedback from older patients who appreciated the care provided by the practice.

Updated 7 February 2017

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 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.
• The practice offered extended hours appointments to provide easier access for patients who worked or who could not attend during normal hours.

Updated 7 February 2017

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

• 72% of patients diagnosed with dementia had had their care reviewed in a face-to-face meeting in the last 12 months, which was comparable to the CCG and the national average of 76% and 78% respectively. Exception reporting was significantly lower than the CCG average in this area.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in their record, in the preceding 12 months was 92%, which was significantly higher than the CCG and national average of 77% and 78% respectively.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice carried out advanced 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 assess whether 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.

Updated 7 February 2017

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 those with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
• 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.
• The number of carers identified by the practice was less than expected for the size of the practice. However, the practice had immediate discussions and had put measures in place to address this and amended their carers policy.