Wellington Road Family Practice

Updated 27 September 2016

Wellington Road Family Practice is a small GP practice situated in Yate in South Gloucestershire. The practice supports approximately 2,441 patients from the local community.

The practice operates from one location.

Wellington Road

Yate

South Gloucestershire

BS37 5UY

The practice is all on one level with consulting rooms and treatment rooms situated off corridors from the central waiting and reception area. There is an independent pharmacy which shares the practice entrance. A NHS dental surgery is attached to the premises. There is parking for a small number of vehicles at the front of the practice. The practice was in the process of completing new build addition to the premises which has included changing the layout internally and creating new consulting rooms and treatment areas.

The practice provides surgeries five days a week and consists of one full-time GP and one part-time GP. There is one practice nurse who works four mornings and one afternoon per week. There is also a health care assistant who works three sessions per week. There is a practice manager, reception and administration team.

There is a system of open appointment surgeries between 9am and 11am and 4pm and 6pm each day. There is no afternoon surgery on Thursdays and reception is closed. However patients are able to contact the GP directly via a mobile phone number and are seen at home or at the surgery by a GP as necessary. The GPs mobile phone number is publicised on the practice website, in the practice leaflet and on the answerphone message is used when the practice is closed. The practice offers a booked appointment system for late afternoon surgeries until 7.30pm on alternate Tuesdays and Wednesdays for anyone having difficulty attending during normal surgery hours.

The practice has a General Medical Services contract with NHS England. The practice is contracted for a number of enhanced services including extended hours access, improving patient’s online access, timely diagnosis and support for patients with dementia and unplanned admission avoidance.

The practice does not provide out of hour’s services to its patients, this is provided by the NHS111 services and BrisDoc. Contact information for this service is available in the practice and on the practice website.

Patient Age Distribution

0-4 years old: 5.2% (the national average 5.9%)

5-14 years old: 10.7% (the national average 11.4%)

Total under 18 years old: 18.9% (the national average 20.7%)

65+ years old: 19.8% (the national average 17.1%)

75+ years old: 9.6% (the national average 7.8%)

85+ years old: 3.2% (the national average 2.3%)

Other Population Demographics

% of Patients with a long standing health condition is 63% (the national average 54%)

% of Patients in paid work or full time education is 56% (the national average 61.5%)

Practice List Demographics / Deprivation

Index of Multiple Deprivation 2015 (IMD): is 11% (the national average 21.8%)

Income Deprivation Affecting Children (IDACI): is 11% (the national average 19.9%)

Income Deprivation Affecting Older People (IDAOPI): is 9.4% (the national average 16.2%)

Patient Gender Distribution

Male 47.8%

Female 52.2%

% of patients from BME populations 2.33%

Patient turnover for 2015 was 7.4%; the national average was 8.5%.

Updated 27 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Wellington Road Family Practice on 25 July 2016. Overall the practice is rated as good. We rated domain of caring as outstanding.

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 in place for reporting and recording significant events.
• Risks to patients 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.
• 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.
• The practice offered flexible access to patients, with the system of open appointment surgeries in the morning and evening. Patients’ needs were accommodated should they contact the surgery and state they were unable to attend during normal hours, we heard how GPs adjusted their hours, stayed later or started earlier should the need arise.
• There were longer appointments available for patients not just for those with a learning disability, or complex health needs.
• Patients with minor injuries were assessed and treated at the practice and if necessary referred to other health providers should the need arise.
• One GP has a special interest in musculo-skeletal medicine and was able to support some patients with treatment at the practice, such as joint injections and acupuncture for pain relief to reduce their need to attend secondary care for treatment.
• The practice staff worked well with patients who had alternative life styles such as the traveller community. The had a positive relationship with the Travellers Liaison Service, and other providers to ensure that there was continuity of care for patients such as ensuring that there was on-going post-natal support when patients moved on.

• The practice staff had a good awareness of domestic abuse and offered appropriate support and a safe haven to patients and others should it be needed.

• The practice hosted sessions for a dietician, counselling service and substance misuse service.

• The practice provided a ‘No Worries’ service offering confidential contraceptive and sexual health services to young people.

• 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. 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.

We saw areas of outstanding practice:

• Patients emphasised that they had felt a strong feeling of being cared for as an individual and as a family. Time, whatever the situation, was given to listen to them and their concerns.
• Patients told us there was a whole team approach to ensuring their needs were met. This was reiterated by the representatives of the three care homes, two for older people and one for younger adults, of which the practice GPs provided a personal service to individuals, took the time to listen and explain to patients and their representatives.
• Information for patients about the services available was easy to understand and accessible.
• We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.
• We were given, by a relative and a health care professional, two examples of the holistic caring approach and the quality of the personal service patient’s relatives received from the practice regarding end of life care.
• We were provided with feedback in regard to the support the GPs provided in the local community. This was within their role as patients’ GPs and in the extra support they gave to local schools; as the safeguarding lead for the clinical commissioning group and their work with the representative of the Identification and referral service(IRIS) for domestic abuse. The senior representatives of the schools told us the extra effort that was made to provide support to vulnerable and at risk young students who were at their schools. This was through providing educational support, a rapid response to assist with a young person’s crisis at the school, providing emergency counselling and clinical help for anxiety, mental health and sexual health.
• Although not formally flagged up by the practice as carers, staff and clinicians recognised the difficulties for some patients and their families to attend the practice. For example, a GP visited a family with twins at home to provide their immunisations so as to reduce the inconvenience and stress for the family to attend the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 27 September 2016

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. The practice provided a caring and supportive service to patients living in care homes.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. 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.

Updated 27 September 2016

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 A&E attendances. Immunisation rates were relatively 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.

• 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.

• The practice provided a ‘No Worries’ service offering confidential contraceptive and sexual health services to young people.

• GPs worked well with local schools to provide support to them with young people, particularly those at risk of harm, provide training to staff and rapid response to support the young people when issues arise.

Updated 27 September 2016

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.

Updated 27 September 2016

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 offered flexible access to patients, with the system of open appointment surgeries in the morning and evening. Patients’ needs were accommodated should they contact the surgery and state they were unable to attend during normal hours, we heard how GPs adjusted their hours, stayed later or started earlier should the need arise.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 27 September 2016

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

• 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 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.

• 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.

Updated 27 September 2016

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 homeless people, travellers and those with a learning disability.

• The practice staff worked well with patients who had alternative life styles such as the traveller community. The had a positive relationship with Travellers Liaison Service, and other providers to ensure that there was continuity of care for patients such as ensuring that post-natal support is provided elsewhere.

• The practice offered longer appointments for all patients not just those identified with a learning disability or complex health needs.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• 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.

• The practice staff had a good awareness of domestic abuse and can offer appropriate support and a safe haven to patients and others should it be needed.