Archived: Penn Manor Medical Practice

Updated 16 February 2017

Penn Manor Medical Practice is located in Penn, a suburb of Wolverhampton in the West Midlands. The practice was situated on the ground and first floors of the building, with services for patients on the ground floor. At the time of our inspection, there were approximately 11,519 patients of all ages registered at the practice. The practice has a higher proportion of patients aged 40 years and above than the expected national average.

The practice team consists of three GP partners and a salaried GP, two male and two female. An advanced nurse practitioner, a nurse practitioner, a practice clinical pharmacist, four practice nurses and three health care assistants currently support the GPs. Clinical staff are supported by a practice manager, and a team of 15 reception and administrative staff, including medical secretaries. In total there are 29 staff employed either full or part time hours to meet the needs of patients. The practice is a training practice for GP registrars. GP Registrars are qualified doctors who undertake additional training to gain experience and higher qualifications in general practice and family medicine.

The practice is open between 8.30am and 6.30pm Monday to Friday, with extended hours between 6.30pm and 7pm every evening except Friday. Telephone calls for emergencies only are answered between 8am and 8.30am. The practice operates a telephone triage system for all GP partner appointments. Patients are initially provided with a telephone consultation and a decision made as to whether the patient needs a face to face consultation. Telephone and face to face consultations are available from 8.30am until 6.30pm.

The practice has a General Medical Services contract with NHS England to provide medical services to its registered patients. It provides Directed Enhanced Services, such as childhood vaccinations and immunisations and the care of patients with a learning disability. The practice is located in one of the less deprived areas of Wolverhampton. People living in more deprived areas tend to have a greater need for health services. There is a lower practice value for income deprivation affecting children and older people in comparison to the practice average across England. The level of income deprivation affecting children of 13% is lower than the national average of 20%. The level of income deprivation affecting older people is also lower than the national average (15% compared to 16%).

Updated 16 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Penn Manor Medical Centre on 5 May 2015. A total of three breaches of legal requirements were found. After the comprehensive inspection, the practice was rated as requires improvement overall.

We issued requirement notices in relation to:

• Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) 2014 Safe care and treatment.
• Regulation 17 HSCA (RA) Regulations 2014 Good governance.
• Regulation 19 HSCA (RA) Regulations 2014 Fit and proper persons employed

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Penn Manor Medical Centre on our website at www.cqc.org.uk

We undertook an announced comprehensive inspection on 28 September 2016 to check that the practice now met legal requirements.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
• Risks to patients were assessed and well managed. The practice had improved its process ensure appropriate recruitment checks had been completed.
• Ongoing audits were driving improvement in performance to improve patient outcomes.
• Patients’ needs were assessed and care was planned, and best practice guidance was followed. Staff had received training appropriate to their roles.
• Patients said they were treated with 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.
• Patients told us that they were able to get appointments when they needed them, however patients also told us when they contacted the practice they could not get an appointment with their preferred GP. Telephone consultations were offered however patients were not happy and felt that these were offered instead of appointments at the practice.
• There was a clear leadership structure and staff felt supported by the management.
• The practice proactively sought feedback from patients.
• The provider was aware of and complied with the requirements of the Duty of Candour.

There was one area where the provider should make improvements:

• Ensure that all reception and administration staff receive safeguarding training in the protection of vulnerable adults.
• Consider pro-actively identifying carers and establishing what support they need.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 16 February 2017

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

• The GPs, advanced nurse practitioner, practice nurses and healthcare assistants had lead roles in chronic disease management.
• The GPs and nurses worked with relevant health care professionals to deliver a multidisciplinary package of care to patients with complex needs.
• The practice Quality and Outcomes Framework (QOF) score for the care of patients with long-term conditions was comparable to the local and national average. For example the practice performance for diabetes related clinical indicators overall was slightly lower than the local Clinical Commissioning Group and England average (80% compared to the local average of 82% and England average of 89%).
• Longer appointments and home visits were available when needed.
• Patients with long term conditions were offered a structured annual review to check that their health and medication needs were being met.

Updated 16 February 2017

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

• Immunisation rates were higher than the local and national averages for all standard childhood immunisations.
• Breastfeeding and baby changing facilities were available at the practice and mothers had access to a breast feeding support and advice worker.
• 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.
• The practice’s uptake for the cervical screening programme was 80% was higher than the local Clinical Commissioning Group (CCG) average of 78% although lower than the England average of 82%.
• Protected daily appointments were available for children of all ages. Urgent appointments and appointments outside of school hours were also available for children.
• We saw positive examples of joint working with other professionals.

Updated 16 February 2017

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

• The practice offered personalised care to meet the needs of the older people in its population. Home visits and flexible appointments were available for older patients.
• Patients aged 75 years plus were offered annual health checks, allocated a named GP and were included on the practice hospital admission avoidance register.
• The practice maintained a register of housebound older patients and older patients who required a home visit.
• Older patients were offered urgent appointments. Patients with enhanced needs were offered longer appointments which gave them more time to discuss health issues with a clinician.

Updated 16 February 2017

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

• The practice was proactive in offering a full range of health promotion and screening that reflects the needs of this age group.
• The practice offered extended hours four evenings a week.
• The practice offered face to face late appointments for workers.
• The practice was proactive in offering online services which included making online prescription and appointment requests.

Updated 16 February 2017

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

• The practice worked with multi-disciplinary teams in the case management of people who experienced poor mental health, including those with dementia.
• The practice maintained a register of patients diagnosed with dementia
• The practice held a register of patients who experienced poor mental health. Clinical data for the year 2014/15 showed that 89% of patients on the practice register who experienced poor mental health had a comprehensive agreed care plan in the preceding 12 months. This
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

Updated 16 February 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice enabled all patients to access their GP services.
• The practice held a register of patients with a learning disability and had developed individual care plans for each patient, carried out annual health checks and offered longer appointments to this group of patients.
• Staff knew how to recognise signs of abuse in vulnerable patients and were aware of how to progress their concerns with the relevant agencies.
• The practice was alerted to other patients whose circumstances may make them vulnerable or may present a risk to ensure that they were registered with the practice if appropriate.
• The practice had told vulnerable patients about how to access various support groups and voluntary organisations.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.