Wigston Central Surgery

Updated 16 November 2017

Wigston Central Surgery provides primary medical services to 12,174 patients in Wigston and the surrounding area from Two Steeples Medical Centre, a purpose built centre which opened in September 2014. Another GP practice, Bushloe Surgery, is also located within the centre.

The practice demographics are similar to those of other practices in the CCG and those nationally, excepting that there are higher numbers people aged 45 or over registered as patients at this practice than the average. The patient demographics are predominantly white British of mixed social classes. There is a high number of care and nursing home users and a low incidence of students, travelling families, substance abusers and sex workers. The practice is not aware of any homeless patients on their list.

At the time of our inspection the practice had four GP partners (31 sessions weekly), three salaried GPs (16 sessions weekly), two advanced nurse practitioners (2.0 whole time equivalent-WTE), two practice nurses (1.9 WTE), and two health care assistants (1.0 WTE). The practice also employed a pharmacist (0.38 WTE) They are supported by a business manager, a practice manager, and a range of administration and reception staff.

There was one GP registrar.

The practice has a General Medical Services Contract (GMS). The GMS contract is the contract for delivering primary care services to local communities. It is not a dispensing practice, although there is a community pharmacy located in the medical centre.

The practice has one location registered with the Care Quality Commission which is Wigston Central Surgery, Two Steeples Medical Centre, 10 Abington Close, Wigston, LE18 2EW.

The practice is open from 8am to 6.30pm Monday to Friday.

Extended hours pre-booked appointments were offered on Monday mornings from 7am to 8am.

Pre-bookable appointments with nurses were available on Mondays from 7am to 8 am and 6.30pm to 7.30pm and on Tuesday from 7am to 8am.

In addition the practice operated a sit and wait consultation system for GPs and advanced nurse practitioners from 8am to 10.15am. All patients who arrived by 10.15am were seen.

The practice is located within the area covered by NHS East Leicestershire and Rutland clinical commissioning group. The CCG is responsible for commissioning services from the practice.

. The practice has a website which we found has an easy layout for patients to use. It enabled patients to find out a range of information about the healthcare services provided by the practice and other healthcare providers.

When the practice is closed, GP out-of-hours services are provided by Derbyshire Health United which is accessed by the NHS 111.

Updated 16 November 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of  Wigston Central Surgery on 17 August 2017. Overall we rated the practice as good.

Our key findings 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, for example as a result of healthcare associated infections were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• The practice was responsive to the needs of patients and tailored its services to meet those needs.
• Patients prescribed high risk medicines were well managed and there was an effective re-call system in place for patients with long term conditions.
• 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.
• Patients said there was continuity of care, with quick and easy access to GPs and nurses.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Effective systems and processes were in place to help ensure carers were supported and their healthcare needs met.
• There was a strong management structure which was effective in accepting and meeting new challenges.
• Staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of the requirements of the duty of candour.

However, there were also areas of practice where the provider needs to make improvements.

The provider should;

• Complete full cycle clinical audits to drive quality improvement.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 16 November 2017

The practice is rated as good for patients with long term conditions.

• GPs held lead roles in the management of patients in this population group.

• Specialist nurses came into the practice to run clinics for some conditions such as diabetes, chronic obstructive pulmonary disease and heart failure.

• The practice utilised patient recall software to help manage patients in this group.

• One stop review clinics negated the need for multiple appointments.

• Patients in this group had individualised care plans.

• There was an effective medicines management system for patients in this group.

• The uptake of diabetic eye screening for eligible patients was 82% compared to the CCG average of 80%

Updated 16 November 2017

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

• The practice offered neonatal and six week mother and baby checks.

• The midwife held antenatal clinics at the practice

• The full range of childhood immunisations was offered. Immunisation rates were comparable to CCG and national averages.

• Baby change and breast feeding facilities were available and the premises were accessible to people with pushchairs.

• There was a children’s’ play area in the patient waiting room.

• The practice facilitated antenatal clinics at the surgery, delivered by the community midwives.

• There was regular contact between health visitors, school nurses and the practice.

• Comprehensive reversible contraceptive services were available.

• On the day appointments were available.

• Unwell children were seen on the day.

• The practice held six weekly meetings with health visitors.

• The percentage of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding 5 years was 84%, which was comparable to local and national averages.

Updated 16 November 2017

The practice is rated as good for older patients.

• Patients over 75 years of age had a named GP.

• Home visits including medication reviews and phlebotomy were available for patients who were unable to attend the surgery.

• An advanced nurse practitioner co-ordinated the care of those in the top 2% of most vulnerable patients and those most as risk of hospital admission and health decline.

• The practice undertook opportunistic dementia screening for patients in this group.

• The computer system in use by the practice alerted staff if the patient was known to be a carer.

• The practice had trained staff working in residential care homes to enable them to undertaken basic tasks such as blood pressure and urine dip-stick testing.

Updated 16 November 2017

The practice is rated as good for patients of working age (including those recently retired and students)

• Extended hours appointments with GPs and nurses were available to meet the needs of patients who could not attend in normal surgery hours.

• Telephone consultations were available.

• Text reminders of appointments were sent where the patient had registered their mobile telephone number with the practice.

• There was online access to appointments and repeat prescriptions.

• The practice was part of the electronic prescribing scheme.

• The practice gave advice and direction of lifestyle and health promotion.

• NHS health checks were offered for patients aged between 40 and 74 years of age.

Updated 16 November 2017

The practice is rated as good for patients experiencing poor mental health including people with dementia.

• The practice had access to a mental health facilitator who held clinics for those on the practice mental health register.

• There was referral to talking therapy with cognitive behaviour therapy being delivered in the surgery.

• The practice offered dementia screening.

• The practice worked with their patient participation group to raise dementia awareness

• The practice kept a register of patients pursuant to the Deprivation of Liberty safeguards.

• All staff had received in the Mental Capacity Act and mental health awareness.

• Patients experiencing poor mental health were offered extended appointments and an annual physical health check.

• Of those patients diagnosed with dementia 84% had their care plan reviewed in a face-to-face review in the preceding 12 months. This was comparable to the CCG and national average.

• The practice had worked hard to identify people living with dementia and as a consequence received The Dementia Champion Award from their CCG for their work in this area.

• Clinical prevalence of dementia was 1.18% which 0.3% higher than the CCG and 0.42% higher than the national average.

Updated 16 November 2017

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

• A GP was the clinical lead for patients in this group.

• The practice had effective systems in place to safeguard people from abuse.

• Patient records to alerted staff to the patient being a vulnerable child or adult.

• Annual physical health checks were offered to patients with a learning disability.

• Extended appointments were offered the patients and their carers.

• There were regular adult and children’s safeguarding meetings.

• There was an open registration policy to meet the needs of the travelling community and others whose circumstances might make them vulnerable.