The Wilson Practice

Updated 13 September 2016

The Wilson Practice is situated in Alton Health Centre, Anstey Road, Alton, Hampshire, GU34 2QX. There are approximately 14,000 patients registered with the practice. The catchment area covers Alton and the surrounding villages. The practice has a spread across all age groups with slightly higher numbers of patients who are in the 65 to 69 years age group. The practice area is one of the least deprived areas of England.

The practice holds a general medical services contract and has six female GPs and four male GPs. Six of the GPs are partners and there is one fixed share partner, two salaried GPs and a registrar who is a doctor who is training to be a GP. The GP team is supported by a business director, a practice manager, nine receptionists, three secretaries, five administration staff, six nurses and three healthcare assistants and a person responsible for minor building repairs and general duties.

The practice has opted out of providing out of hours services to their own patients; these are provided by Hampshire Doctors on Call, via 111.

We carried out a desk based focussed inspection. We did not visit the practice as the practice were able to submit evidence they were meeting the regulations.

Updated 13 September 2016

Letter from the Chief Inspector of General Practice

We carried out a desk based focused inspection of The Wilson Practice on 15 July 2016. This inspection was undertaken to check the practice was meeting regulations. At our previous inspection on 5 February 2015, we found breaches of regulations relating to the safe delivery of services. At that time the practice was rated good for providing effective, caring, responsive and well-led services and requires improvement for safe. The practice was rated as good overall.

Following our review on 15 July 2016, we found the practice had made improvements since our last inspection on 5 February 2015 and we found the practice was meeting the regulations that had previously been breached.

Key findings:

• The practice had reviewed and made changes to infection control processes and ensured all staff had received appropriate training.

• The practice also reviewed arrangements for chaperoning and ensured all staff that carried out this role were competent. Signage on chaperoning was improved to ensure patients were aware that they could request a chaperone. The practice also reviewed the chaperone protocol which detailed how use of chaperones would be recorded.

We have amended the rating for safe to reflect these changes. The practice is now rated good for the provision of safe, effective, caring, responsive and well led services. The practice remains rated as good overall.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 16 July 2015

The practice is rated as good for the care of people with long-term conditions. Computer templates and protocols were in place to coordinate appropriate effective care. Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Annual review recalls were sent for all patients with long term conditions. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check whether their health and medication needs were still being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 16 July 2015

The practice is rated as good for the care of families, children and young people. The practice encouraged families to have the same named usual GP. Regular meetings were held with other health professionals, such as health visitors, to discuss vulnerable patients. For example those who were pregnant and patients at risk of harm. Systems were in place to code patients’ records to identify children at risk of harm. All staff had received training in safeguarding adults and children, and this had also covered domestic violence and staff could demonstrate what action they would take if needed. The practice had a dedicated immunisations clinic and practice nurses were trained to monitor children with asthma. If young people or children did not attend for appointments there were protocols in place to contact the family and offer an alternative date and time. Longer appointments were offered for six week baby checks. The practice had contact with local schools and colleges and community nurses assigned to work at those places.

Updated 16 July 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of older patients. This included personal lists and practice based or domiciliary clinics, for those over 75 years of age, consisting of half hour appointments. Regular meetings were held with integrated care and multi-disciplinary care teams. Patients receiving end of life care and support also had care plans which were shared using the special notes system with other out of hours providers. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 16 July 2015

The practice is rated as good for the care of working-age people (including those recently retired and students). The needs of this population group 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 of this group. NHS health checks were offered to all patients under the public health scheme. We found that travel clinics were available in the late evening to allow working patients to attend.

Updated 16 July 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice maintained personal lists to provide continuity of care. Follow ups for patients with mental health conditions who had had a hospital admission were available at the practice or by a telephone call. The practice carried out virtual weekly ward rounds and worked closely with Older Patients Mental Health services to provide coordinated care. Patients who were subject to deprivation of liberty safeguards had care plans in place. The practice proactively used a toolkit to diagnose dementia to identify patients early and put appropriate support and treatment in place.

Updated 16 July 2015

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 including those with a learning disability. It had carried out annual health checks for people with a learning disability. It offered longer appointments for people with a learning disability. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. Vulnerable patients were advised of 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.