Woden Road Surgery

Updated 14 July 2017

Woden Road Surgery is registered with the Care Quality Commission (CQC) as a partnership. The practice is close to main transport links for patients travelling by public transport. Parking is available for patients travelling by car. The practice is a two storey building with access for patients on the ground floor.

The practice team consists of four GP partners and two salaried GPs, three male and three females. The GPs are currently supported by two practice nurses and an assistant practitioner (healthcare assistant). Clinical staff are supported by a business manager, an office assistant, a medical secretary and six medical receptionists. The practice is a training practice for medical students, medical graduates and GP registrars.

The practice is open between 8.50am and 6.15pm Monday, Tuesday and Wednesday, 8.50am to 1pm on Thursday and Friday 8.50am to 6pm. The practice telephone lines are open at 8.30am. Appointments times with a GP are Monday to Friday 9am to 11am, Monday and Wednesday 3.30pm to 6pm, Tuesday 3pm to 6pm and Friday 3pm to 5.30pm. Appointments with a practice nurse are available Monday to Friday 9am to 11am, Monday, Tuesday and Wednesday 3.30pm to 6pm and Friday 3pm to 5.30pm. This practice does not provide an out-of-hours service to its patients but has alternative arrangements for patients to be seen when the practice is closed. Patients are directed to Wolverhampton Doctors on Call Limited when the practice is closed at lunchtime and on a Thursday afternoon. At all other times when the practice is closed, the patients are directed to the out of hours service Vocare via the NHS 111 service.

The practice has a General Medical Services contract with NHS England to provide medical services to approximately 6,670 patients. It provides Directed Enhanced Services, such as childhood vaccinations and immunisations and minor surgery. The practice is located in one of the most deprived areas of Wolverhampton. People living in more deprived areas tend to have a greater need for health services. There is a higher practice value for income deprivation affecting children and older people in comparison to the practice average across England. The level of income deprivation affecting children of 37.5% is higher than the national average of 20%. The level of income deprivation affecting older people is higher than the national average (35% compared to 16%).

Updated 14 July 2017

Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection at Woden Road Surgery on 15 August 2016. The overall rating for the practice was Good with Requires Improvement for providing safe services. The full comprehensive report on the August 2016 inspection can be found by selecting the ‘all reports’ link for Woden Road Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 28 June 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulation that we identified at our previous inspection on 16 August 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• There was an open and transparent approach to safety and there was a system in place for reporting and recording significant events. The provider had reviewed how they shared the outcome and learning from significant events. Information was shared at monthly staff specific meetings. The sharing of information and learning could be further improved by periodically discussing all significant events that have occurred with the whole staff team.
• Risks to patients were assessed and well managed. Improvements had been made to the management of high risk medicines and recruitment procedures. Systems were in place for monitoring and review of prescriptions that had not been collected.

We also saw the following best practice recommendations we previously made in relation to providing safe, caring and responsive services had been actioned:

• The provider had introduced a system for checking the cleanliness of the patient facilities through out the day.
• Staff had attended fire safety, health and safety and basic life support training and to provide them with the skills needed to deal with unexpected emergencies.
• The provider had reviewed practices around maintaining confidentiality in the reception area. Notices were displayed to inform patients that they could request to speak with a member of staff in private if they wished to.
• The provider had removed the book for recording complaints and concerns from the reception area. Patients wishing to raise concerns were encouraged to put their concerns in writing or offered the opportunity to speak with the business manager.
• Information about registering as a carer was displayed in the waiting room, in addition to information signposting carers to support services. The provider had increased the number of carers identified from 0.7% to 1.2% of the practice list.
• The provider had reviewed access to the building for patients with mobility difficulties. The external door was left open throughout the day, with notices asking patients not to close the door. A door bell to alert staff that a patient needed assistance was in place by the external door with a prominent notice informing patients to ring for assistance. The provider was in the process of obtaining quotes for the installation of an automatic door.

However, there were still areas of practice where the provider could make improvements.

The provider should:

• Consider periodically discussing all significant events that had occurred with the whole staff team.
• Consider discussing medicine and safety alerts at a central forum and recording actions taken on a central log.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 13 January 2017

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

• The GPs, nurses and healthcare assistants had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• The GPs and nurses worked with relevant health care professionals to deliver a multidisciplinary package of care to patients with complex needs.
• The practice Quality and Outcomes Framework (QOF) results for the care of patients with long-term conditions were similar to or higher in most clinical areas compared to the local Clinical Commissioning Group (CCG) and England average. For example the percentage of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months was 88% compared with the CCG average of 87% and England average of 88%.
• Specific GP led clinics were held for patients whose diabetes was not well controlled.
• Patients with long-term conditions were signposted to community support networks, which helped to educate patients on their condition and encouraged self-care and socialisation.

Updated 13 January 2017

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

• 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.
• Babies were given their first immunisations on the same day as mothers were offered their six week postnatal check.
• Immunisation rates were relatively high for all standard childhood immunisations.
• The practice’s uptake for the cervical screening programme was 85%, which was higher than the local CCG average of 78% and England average of 82%.
• Protected daily appointments were available for children of all ages and children aged under the age of one were given priority and seen on the day. Appointments were available outside of school hours and urgent appointments were available for children.
• We saw positive examples of joint working with other professionals.

Updated 13 January 2017

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

• The practice offered personalised care to meet the needs of the older patients in its population. Home visits and flexible appointments were available for older patients.
• Patients aged 75 years plus were offered annual health checks, allocated a named GP and were included on the practice hospital admission avoidance register.
• The practice provided a service to patients living in care homes. Staff had access to a direct telephone number at the practice for patients included on the practice hospital admission avoidance register.
• Older patients were offered urgent appointments for those with enhanced needs plus longer appointments which gave them more time to discuss health issues with a clinician.

Updated 13 January 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The practice offered telephone consultations and online services, which included online prescription requests, booking appointment and access to patients own summarised medical records.
• Extended hours are offered by appointment only on Monday and Wednesday evenings from 6.30pm to 7.15pm and early morning appointments from 7.30am to 8am one morning per week.
• Patients had access to healthy lifestyles clinics carried out at the practice.
• Patients were signposted to a full range of health promotion and screening that reflected the needs of this age group.

Updated 13 January 2017

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

• The practice worked with multi-disciplinary teams in the case management of people who experienced poor mental health, including those with dementia.
• The practice held a register of patients who experienced poor mental health. Clinical data for the year 2014/15 showed that 87% of patients on the practice register who experienced poor mental health had a comprehensive agreed care plan in the preceding 12 months. This
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. Counselling clinic sessions were held at the practice with an experienced mental health counsellor based in the community.
• The practice maintained a register of patients diagnosed with dementia. The percentage of patients diagnosed with dementia whose care had been reviewed in a face to face review in the preceding 12 months was 90%, which was higher than the local CCG average of 82% and England average of 84%.

Updated 13 January 2017

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

• The practice had a register of 49 patients with a learning disability and worked with the local community learning disabilities nurses to ensure patients received annual health checks. Patients were offered a choice of appointment either at the practice or at their home. Information for this group of patients was also available in pictorial format.
• The practice was alerted to other patients whose circumstances may make them vulnerable or may present a risk to ensure that they were registered with the practice if appropriate. This included patients who were identified as being homeless and patients who misused substances that could harm their health and wellbeing.
• The practice had told vulnerable patients about how to access various support groups and voluntary organisations.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.