Archived: Westfield Medical Centre

Updated 21 March 2016

The national GP patient survey results published on July 2015 showed the practice was performing comparable to local and national averages. There were 452 survey forms distributed and 79 were returned. This was a response rate of 18% which represented less than 1% of the practice’s patient list.

The practice is located in one of the most deprived areas of Leeds. It has a patient list size of approximately 3598 with a higher than national average of patients who are under the age of 34.

The practice is located in a two storey purpose built building and is located on the first floor. This is accessible by stairs and there are also two lifts to support disabled access.

The practice has good working relationships with local health, social and third sector services to support provision of care for its patients, some of which are co-located in the building. For example; adult social care and children and young people social care.

The service is provided by one lead GP (male) and two female salaried GPs, two regular locum GPs also worked at the practice. The GPs are supported by two practice nurses and a health care assistant. The clinical staff are supported by a practice manager, and experienced team of administrative and secretarial staff.

The practice is open from 8am to 6.30pm Monday to Friday, however the telephone goes across to the out of hours service from 6pm each evening so patients wishing to access the service must visit the practice in person. Extended hours are provided on Thursday from 6.30pm-7pm and three Saturdays each month from 10.15am to 12.15am.

When the practice is closed out-of-hours services are provided by Local Care Direct, which can be accessed via the surgery telephone number or by calling the NHS 111 service.

Personal Medical Services (PMS) are provided under a contract with NHS England. The following regulated activities are provided by Dr Prakash Babu from Westfield Medical Centre; Treatment of disease, disorder or injury; Diagnostic and screening procedures; Family planning and

Maternity and midwifery services

Updated 21 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Westfield Medical Centre on 14 October 2015. Overall the practice is rated as good for providing safe, effective, caring, responsive and well-led care for all of the population groups it serves.

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 was in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• The practice held a register of the 2% of patients who were vulnerable or housebound and at risk of an unplanned hospital admission. These patients were given same day appointments when contacting the practice and longer appointment times were allocated.
• The practice were in the process of signing up to the Year of Care Initiative. This initiative was aimed at encouraging patients with long term conditions to understand their condition and select their own personal health and lifestyle targets.
• The practice had a process in place to follow up patients who had attended accident and emergency (A&E) and those patients who had unplanned hospital admission.
• Patients said they were treated with compassion, dignity and respect and were involved in care and decisions about their treatment.
• Patients were positive about access to the service. They said they found it easy to make an appointment, there was continuity of care and urgent appointments were available on the same day as requested.
• Patients registered with the practice had access to a heath trainer. Health trainers help their clients to assess their lifestyles and wellbeing, set goals for improving their health, agree action-plans, and provide practical support and information that will help people to change their behaviour.
• Information about services and how to complain was available and easy to understand.
• There was a clear leadership structure and staff were supported by management.
• The practice held two weekly clinical meetings to ensure information was communicated .
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw areas of outstanding practice:

• The practice had identified diabetes as a priority area and worked with the locality to deliver dedicated specialist community nursing time into the practice.

• The practice had information displayed in Eastern European languages due to the increasing numbers of Eastern European patients registering with the practice.

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However, there were two areas of practice where the provider should make improvements:

• Complete care planning templates in all cases following mental health reviews.
• Establish a system of hard wiring vaccination fridges as recommended by Public Health England.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 March 2016

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

• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. The practice nurses had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Longer appointments and home visits were available when needed.
• Patients who required palliative care were provided with support and care as needed, in conjunction with other health care professionals.
• The practice worked closely with Leeds Community Healthcare and the Better for Me programme. This was a programme run by Leeds Community Healthcare which was aimed at working with patients to achieve better self management of their long term conditions.
• The practice had identified diabetes as a priority area and worked with the locality to deliver dedicated specialist community nursing time into the practice. This service was utilised to support more complex diabetic piatents and upskill the nursing staff in the locality.
• A GP at the practice attended the patient forum to give talks on long term conditions such as diabetes and arthritis to educate patients.
• The practice offered screening to those patients at high risk of diabetes. Patients at risk of diabetes were recalled annually and provided with lifestyle advice to reduce the risk of developing the condition.
• The practice were in the process of signing up to the Year of Care Initiative. This initiative was aimed at encouraging patients with long term conditions to understand their condition and select their own personal health and lifestyle targets.
• The practice hosted Health Trainer clinics offering support to patients and supporting them to make lifestyle changes.

Updated 21 March 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 accident and emergency (A&E) attendances.
• Patients and staff told us children and young people were treated in an age-appropriate way and were recognised as individuals.
• Appointments were available outside of school hours and the premises were suitable for children and babies. All children who required an urgent appointment were seen on the same day as requested.
• The practice worked with midwives, health visitors and school nurses to support the needs of this population group. For example, ante-natal, post-natal and child health surveillance clinics.
• Sexual health and contraceptive and cervical screening services were provided at the practice.

Updated 21 March 2016

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

• The practice provided proactive, responsive and personalised care to meet the needs of the older people in its population. Home visits and urgent appointments were available for those patients with enhanced needs.
• The practice worked closely with other health and social care professionals, such as the district nursing team, to ensure housebound patients received the care they needed.
• The practice had a register of the 2% of patients who were vulnerable or housebound and at risk of an unplanned hospital admission. These patients were given same day appointments when contacting the practice and longer appointment times were allocated.
• The practice worked closely with other co-located services such as benefits advice and adult social care.

Updated 21 March 2016

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

• The needs of these patients 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 offered extended hours on Thursday evenings until 7pm and the first three Saturdays of every month.
• The practice offered online services as well as a full range of health promotion and screening that reflected the needs for this age group. For example, cervical screening, NHS health checks for patients between the ages of 40 and 74.
• The practice offered a travel vaccination clinic.
• The practice offered a text messaging service to remind patients about their appointment.

Updated 21 March 2016

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

• The practice regularly worked with multidisciplinary teams in the case management of people in this population group, for example the local mental health team. Patients and/or their carer were given information on how to access various support groups and voluntary organisations, such as Carers Leeds.
• The practice carried out mental health reviews which included physical health and lifestyle. However, care planning templates were not always completed on the clinical system. The practice had signed up to be a dementia friendly practice and all staff had received training. This gave them a greater understanding of how to support pateints with dementia and their carers.
• The practice carried out dementia screening on patients at risk of developing dementia.

Updated 21 March 2016

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 and regularly worked with multidisciplinary teams in the case management of this population group.
• Information was provided on how to access various local support groups and voluntary organisations.
• Longer appointments were available for patients as needed.
• Staff knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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 practice worked closely with other services in the Reginald Centre building, which hosted services such as benefits advice and adult social care.
• The practice referred to drug and alcohol clinics as appropriate to ensure patients were getting the support they needed and offer intervention.