Wolverley Surgery

Updated 21 April 2017

Wolverley Surgery is a rural dispensing GP practice which provides primary medical services under a General Medical Services (GMS) contract to a population of approximately 3,100 patients living in Wolverley and the surrounding areas in Kidderminster. A GMS contract is a standard nationally agreed contract used for general medical services providers.

The practice operates from a single storey building, which accommodates other members of the primary health care team. For example, the district nursing team, pharmacy adviser, physiotherapist, chiropodist, counsellor and drug and alcohol adviser. The practice has parking facilities and disabled access.

The practice population has a higher than average number of patients aged 45 to 80 years and lower than average number of patients in the 0 to 10 years age group. National data indicates that the area is one that does not experience high levels of deprivation. The practice population is predominantly made up of patients of white British ethnic origin.

There are two GP partners, one male and one female. The practice employs two practice nurses, a health care assistant, a practice manager, an office manager who are supported by a team of administration and reception staff. The practice is a dispensing practice dispensing to approximately 1,800 patients who live more than one mile from a pharmacy. This is staffed by a team of trained dispensary staff.

The practice offers a range of services including minor surgery, long term condition monitoring, cervical cytology, family planning, child health services and phlebotomy (blood taking).

The practice premises is open on Mondays, Wednesdays, Thursdays and Fridays from 8am until 6.30pm, and Tuesdays from 7am until 7pm. Extended hours appointments are offered from 7am until 8am and from 6.30pm until 7pm on Tuesdays for pre-bookable appointments only.

The dispensary is open Monday to Friday from 8.30am until 6pm. Between 6pm and 6.30pm a collection service is available from the practice reception. When the practice is closed cover is provided by the out of hours service Care UK, who can be contacted via NHS 111. 

Updated 21 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Wolverley Surgery on 19 January 2017. 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 for reporting and recording significant events which staff were aware of and participated in.
• Risks to patients were assessed and well managed across the practice and were regularly reviewed.
• There was evidence of regular audit and review of their practises to improve patient care which included palliative care, after death reviews and implementation of systems to ensure appropriate actions were taken from safety alerts.

• 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.
• Patients consistently reported high levels of satisfaction with all aspects of care at the practice. The said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. We received many examples from patients of how the caring and compassionate nature and actions of the GPs and staff had had a positive impact on their lives. Reception and dispensary staff were reported by patients to be exceptionally friendly, helpful and accommodating at all times.
• The practice had a carer’s champion who worked closely with the Worcestershire Carers Association and had identified a higher than average number of carers. The practice also had good links and communication with the lead nurse for patients with a learning disability.
• Information about services and how to complain was available and easy to understand and 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 as well as a triage system.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff reported being well supported at all times 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:

• Introduce a formal record of actions taken in response to recommendations from the Legionella risk assessment.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 21 April 2017

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

• GPs and nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• The practice had good recall systems for patients with long term conditions.
• The practice utilised standard templates to ensure consistent recording of patient information and personal care plans were completed for patients with chronic obstructive pulmonary disease (COPD), asthma and diabetes. 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.
• The percentage of patients with diabetes whose last cholesterol measurement was within the recommended level was 77% compared to the CCG and national averages of 72% and 70% respectively.
• The percentage of patients with chronic obstructive pulmonary disease (COPD) who had had a review by a healthcare professional in the preceding 12 months was 88% compared to the CCG and national averages of 85% and 79% respectively.
• Longer appointments and home visits were available when needed.

Updated 21 April 2017

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

• There were systems 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. 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 comparable with the CCG and national averages. The percentage of eligible women who had received cervical screening in the previous five years was 82% which was in line with the CCG average of 83% and the national average of 82%.
• The practice offered a full range of family planning services and sexual health advice.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The GPs visited patients at home following delivery of their babies as well as visits for patients following difficulties in early pregnancy.
• We saw positive examples of joint working with midwives and health visitor.

Updated 21 April 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 enhanced service for admission avoidance and provided support where necessary.
• The GPs were proactive in advanced care planning and were auditing this six monthly. They had seen improvements in completion of ‘do not attempt cardio pulmonary resuscitation’ (DNACPR) forms, advanced care planning and improved communication with the out of hours service as a result.
• The practice contacted all older people following A&E admission by telephone or carried out a home visit to determine if there were any preventable factors regarding readmission.
• The practice had engaged in the Frail Elderly Scheme and the health care assistant visited any patient over 75 who had not been seen in the last three months. This scheme was no longer funded but they had continued this service as they saw benefits to patients.
• The practice had worked with the local school and agreed to identify older patients who would be suitable to participate in a project to reduce isolation, encourage socialisation and share experiences with young people.
• Blood tests were arranged in the patient’s own homes for those who could not attend the surgery.
• The practice had a dedicated telephone line for care homes, paramedics and community teams to contact the practice to prevent delay.
• The dispensary offered a delivery service for older housebound patients.
• GPs carried out a monthly ward round at the local care home.

Updated 21 April 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 reflected the needs for this age group.
• The practice operated a same day urgent triage service and telephone consultations.
• Extended hours appointments were available both morning and evening on Tuesdays.

Updated 21 April 2017

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

• 82% 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 national averages of 85% and 84% respectively.
• 90% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive care plan documented in their record, agreed between individuals, their family and/or carers as appropriate, which was comparable to the CCG average of 92% and national average of 91%.
• 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 and had access to an in-house counsellor.
• The practice had a system to follow up patients who had attended (A&E) 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 21 April 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 and those with a learning disability. The practice had a learning disability lead GP who had contact with the local area lead nurse. Patients with a learning disability were offered annual reviews and longer appointments to facilitate this.
• Patients reported that GPs contacted them directly if they had long term health problems when they had not seen then for some time and visited patients who had experienced difficult health and life changing experiences such as bereavement.
• Vulnerable patients and those at risk of harm were flagged on the system to alert staff to this.

• The practice had identified 126 carers which represented 4% of the practice population. They had appointed a carer’s champion who maintained a register of carers and with patient consent, shared information with the Worcestershire Carer’s Association. They had a specific link person from the carers association and had regular contact with them. They facilitated quarterly drop in sessions at the practice to enable carers to attend and get more information about services and support available to them. The carers champion wrote to all patients on the carers register to inform them that the carers association would be holding the drop in session and also arranged meetings in between these times for carers who needed to speak with the carers support worker. Carers were given priority appointments to enable them to attend with the patient they were caring for and the practice facilitated appointments to meet the needs of the carers who needed appointments themselves.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice had carried out three audit cycles regarding end of life care to work towards ensuring they were carrying out the wishes of patients and enabling them to die in a place of their choice as well as having advanced care planning documented. This was scheduled to continue.
• 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.