Willenhall Oak Medical Centre

Updated 27 March 2017

Willenhall Oak Medical Practice is a training practice based at 70 Remembrance Road, Coventry CV3 3DP.

The practice has level access from the car park to all treatment rooms. It has a clinical team of two GP partners, two salaried GPs and one trainee GP, consisting of two females and three males; two practice nurses and a healthcare assistant. The non-clinical team consists of a practice manager, a senior receptionist, an administrator and three receptionists.

The practice is readily accessible for people who use wheelchairs and by parents with pushchairs. A portable hearing loop system is available and there are quiet waiting facilities for patients who find the main waiting area can cause anxiety. Private space is available for breast-feeding. Patients can check-in using a self-service kiosk, which provides instructions in several languages.

The practice serves a patient list of 3836 and is in an area of very high deprivation. Of the patient list, 57% are living with a long-term condition and 65% are in paid employment or full time education.

Appointments are from 8.30am to 6pm Mondays to Wednesdays and Fridays and 8am to 3.30pm on Thursdays. Between 7pm and 9pm patients can book appointments at a local health centre and on weekends four local practices offered appointments to Willenhall Oak patients. Outside of these hours patients were directed to the NHS 111 service.

We had not previously carried out an inspection at this practice.

Updated 27 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Willenhall Oak Medical Centre on 6 December 2016. 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. Learning was embedded in the outcomes of incident investigations.
• Risks to patients were assessed, well managed and acted upon.
• 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.
• There was significant training provision in the practice and the clinical team included a GP trainer and two GP tutors. Feedback from medical trainees was consistently positive.
• Feedback from patients was very positive and the practice demonstrated a continual focus on improving access to appointments including alternative means of access and out of hours provision. Staff used internal surveys to understand patients’ views of their experience and improve the service. The practice had recently established a patient participation group who were in the process of establishing their role and the improvements they could make.
• 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. Staff were asked to contribute to the business development plan and had regular opportunities to give feedback to the senior team.
• The provider was aware of and complied with the requirements of the duty of candour.
• Staff demonstrated a consistent and proactive response to ensuring the safety and protection of patients with safeguarding needs or specific vulnerabilities that went above and beyond usual processes.

There was one area in which the provider should make an improvement:

• The practice should take action to ensure there is documented, trackable evidence of the implementation of new national guidance, including from the National Institute of Health and Care Excellence.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 27 March 2017

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

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority and offered same day access. GPs with special interests or specialist training offered a range of clinics based on the needs of the local population. For example, the practice had one GP with a special interest in diabetes who offered a range of services, including retinal screening.
• The practice was ranked sixth out of 31 local practices for the number of patients successfully completing four and 12 week smoking cessation plans.
• Longer appointments and home visits were available when needed. The practice held bi-monthly multidisciplinary meetings with the community matron and district nurses to review patients with long term conditions and complex needs.
• GPs conducted home follow-ups after patients were discharged from hospital.
• All patients with complex needs had a named GP and a structured annual review to check their health and medicines needs were being met.
• Services for patients living with cancer were available, including planning, multidisciplinary condition management and the practice contributed to a national audit in cancer awareness.
• Health promotion clinics were available for respiratory conditions and diabetes.

Updated 27 March 2017

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 attendances.
• Staff had taken action to improve immunisation rates and were proactive in engaging with new parents to ensure they attended the practice for post-natal appointments.
• 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.
• We saw positive examples of joint working with midwives, health visitors and school nurses.
• All children were offered same-day access to clinical staff.

Updated 27 March 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. For example, where patients were considered to be at high risk of hospital admission, they were given priority access to home visits.
• The practice was responsive to the needs of older people and offered urgent and extended appointments and a range of vaccinations. Staff offered vaccinations at home for housebound patients and there was a robust system in place to encourage uptake.
• The practice used a frailty pathway to care for patients aged 60 and over. This was used to prevent unnecessary hospitalisation and ensure patients were discharged as soon as they were medically stable.
• Staff proactively engaged with secondary care and community providers to ensure patients received the most appropriate care.

Updated 27 March 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. This included appointments bookable 24-hours a day by automated telephone service.
• The practice was proactive in offering online services, including online prescribing, as well as a full range of health promotion and screening appropriate to this age group.
• Practice nurses offered flexible clinic times during the day to improve access for people around their work hours.
• The practice offered in-house phlebotomy services.
• Students were offered appropriate immunisations.
• Minor surgery was available including muscle injections, which was a common need in the local population. This was operated in a way that meant people did not need to take time off work for the procedure.

Updated 27 March 2017

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

• 87% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, compared with the Clinical Commissioning Group (CCG) average of 82% and the national average of 84%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia and substance addiction.
• The practice carried out advance 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 according to their individual needs.
• The practice had a system in place to follow up patients who had attended accident and emergency 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.
• The practice offered opportunistic screening for dementia and recognised the needs of people caring for those with dementia by referring them to specialist nurses for support.

Updated 27 March 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 including those with a learning disability or mental health needs. All patients were invited to an annual health check and had an annual care plan review.
• The practice offered longer appointments for patients with a learning disability and reception staff telephoned each patient in advance of their appointment to remind them of the details.
• Patients with mental health needs whose condition made them particularly vulnerable were offered same-day appointments. This reduced the risk amongst patients who had a history of self-harm, suicide attempt and/or substance addiction.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients, including bi-monthly meetings with community matrons and district nurses.
• 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 and a policy was in place to enable them to escalate concerns to appropriate teams. Staff had completed training on how to recognise and respond to female genital mutilation. 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.