• Doctor
  • GP practice

Wilson Street Surgery

Overall: Outstanding read more about inspection ratings

11 Wilson Street, Derby, Derbyshire, DE1 1PG (01332) 332628

Provided and run by:
Wilson Street Surgery

Latest inspection summary

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Background to this inspection

Updated 19 September 2016

Wilson Street Surgery provides primary medical services to approximately 14200 patients through a general medical services contract (GMS). The practice has a branch surgery located at Taddington Road, Derby, DE21 4JU.

The practice is located in premises close to Derby city centre. The practice has car parking, disabled parking and cycle parking and is accessible by public transport.

The level of deprivation within the practice population is above the national average. The practice population is in the second most deprived decile meaning that it has a higher proportion of people living there who are classed as deprived than most areas.

The clinical team comprises ten GP partners (five male and five female) and six practice nurses. At the time of the inspection there were three GP registrars working in the practice. (A GP registrar is a qualified doctor who is training to become a GP through a period of working and training in a practice)

The clinical team is supported by a full time practice manager, two part time assistant practice managers and a team of reception and administrative staff.

The practice opens from 7am to 6.30pm Monday to Friday. From 7am to 8am the practice opens for extended hours consultations; reception opens at 7.30am. Consulting times are from 7am to 10.30am, from 11am to 1pm and from 3pm to 6pm daily. There are no routine GP appointments offered on Wednesday afternoons although emergency appointments are offered.

The practice has opted out of providing out-of-hours services to its own patients. This service is provided by Derbyshire Health United (DHU) and is accessed via 111.

Overall inspection

Outstanding

Updated 19 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Wilson Street Surgery on 9 March 2016. Overall the practice is rated as outstanding.

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

  • There was an open and transparent approach to safety and effective systems in place to report and record significant events.
  • Risks to patients were assessed and 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. A number of clinical staff had undertaken additional training to enhance their skills and had developed areas of special interest to support them in taking lead roles within the practice.
  • Feedback from patients regarding their care and treatment was positive. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • 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.
  • Although some patients reported it could be difficult to get through to the practice by telephone, they said they found it easy to make an appointment with a GP and there was continuity of care, with urgent appointments available the same day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear understanding of the needs of the local population and services were offered to meet these needs. The practice was committed to removing barriers to access for the most vulnerable patients and regularly provided outreach sessions at the local homeless shelter.
  • There was a clear leadership structure and staff felt supported by management. Staff highlighted the supportive culture within the practice.
  • The practice proactively sought feedback from staff and patients, which it acted on.

We saw several areas of outstanding practice:

  • The practice demonstrated a strong commitment to improving access to healthcare for people who were vulnerable. For example the practice provided regular outreach sessions at a local homeless shelter and also provided flu clinics at a local day centre for people who were considered vulnerable. Feedback from community based staff working with vulnerable patients was positive about the service offered by the practice.
  • There was a commitment to the identification and support of carers within the practice. The practice had a wide range of available information to support carers and used all opportunities to identify new carers. The practice had identified over 4% of their practice population as carers. In addition to offering health checks and flu vaccinations, events were organised to support and identify carers which coincided with carers week and mini pamper sessions were provided.

The areas where the provider should make improvements are:

  • Continue to review telephone access for patients to improve the ease of patients contacting the practice by telephone.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

People with long term conditions

Good

Updated 19 September 2016

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

  • Clinical 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 100% which was above the CCG average of 93% and the national average of 89%. Exception reporting for diabetes related indicators was above local and national averages; however, we were assured that the practice was exempting patients in line with guidance.
  • 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. Patients with more complex needs were seen more often as required.
  • For patients with the most complex needs, a named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care. Regular multidisciplinary team meetings were held and the practice worked closely with their attached care coordinator who was present in the practice two and a half days per week.

Families, children and young people

Good

Updated 19 September 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. The practice held regularly safeguarding meetings with relevant professionals.
  • Immunisation rates for some standard childhood immunisations were below local and national averages. We saw that the practice encouraged attendance and had tried initiatives such as offering vaccination clinics in the school holidays. The practice also worked closely with community based health care staff to increase attendance.
  • The practice operated a catch-up programme for immunisations, coordinated by their practice nurses.
  • 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.
  • 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 and feedback from these staff was positive about the practice.

Older people

Good

Updated 19 September 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.
  • All older people were encouraged by the practice to attend for flu and shingles vaccinations as appropriate. In addition to being reminded during appointments, there was information displayed in the waiting areas to encourage attendance.

Working age people (including those recently retired and students)

Good

Updated 19 September 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. For example, the practice offered extended hours services from 7am on a daily basis to facilitate access for working patients.
  • The practice offered NHS health checks undertaken by their practice nurses for relevant patients.
  • The practice aimed to engage with this group in ways which were relevant and accessible to them, for example, the practice had a presence on social media and engaged with patients via email.
  • 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 a full range of contraceptive services to patients including implant and coil fits. Implants and coils were fitted by three specifically trained GPs.

People experiencing poor mental health (including people with dementia)

Outstanding

Updated 19 September 2016

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

  • 92.8% of patients with a mental health condition had a documented care plan in the last 12 months which was above the CCG average of 91.8% and the national average of 88.3%.
  • 84.4% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was in line with the local average of 85.4% and the national average of 84%.
  • 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 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.

People whose circumstances may make them vulnerable

Outstanding

Updated 19 September 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 homeless people, carers and those with a learning disability.
  • Longer appointments were offered to patients with a learning disability and for those who needed them.
  • The practice provided the secure unit services for the county. This meant the practice saw all of the patients who had been placed on the violent patient list. Appointments were offered three evenings per week on a pre-bookable basis outside of normal surgery hours.
  • Where required patients who needed to use an interpreter were offered one and a longer appointment if needed.
  • The practice regularly worked with other health care professionals in the case management of vulnerable patients. Feedback from professionals working with vulnerable patients was positive about the practice.
  • The practice informed vulnerable patients about how to access various support groups and voluntary organisations. Efforts were made to engage with vulnerable groups. For example, the practice had a week of celebrations to mark their 120th anniversary and one day was dedicated to homelessness.
  • Outreach clinics were offered in the local homeless hostel three times per week and the practice also undertook flu clinics at a local day centre for vulnerable people. Homeless patients were also able to access services at the practice.
  • 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.