Archived: Parkfield Wolverhampton Medical Services Ltd Also known as Ettingshall Medical Centre

Updated 1 June 2016

Parkfield Wolverhampton Medical Services Ltd (also known as Ettingshall Medical Centre) is one of two practices in Wolverhampton that was set up by three GPs who are also the directors for the practices. The practice is located in a deprived area of Wolverhampton and provides Primary Medical Services (PMS) to a population of approximately 3,882 patients. The practice operates from a purpose built healthcare facility. The practice has a higher proportion of patients between the ages of 0-4 years, 20-39 years and 85+ years compared with the practice average across England. There is a higher practice value for income deprivation affecting children and older people in comparison to the practice average across England.

One of the GP/directors (female) works at this practice and is supported by two salaried GPs, (one female and one male). Further clinical support is provided by an advanced nurse practitioner, a practice nurse prescriber, a nurse practitioner, a practice nurse and a healthcare assistant. In total there are 18 staff employed either full or part time hours. The practice is a training practice for GP registrars to gain experience and higher qualifications in general practice and family medicine.

The practice is open from 8am to 8pm Monday and Wednesday, 8am to 6.30pm Tuesday, Thursday and Friday and 8am to 12pm on Saturday. Extended surgery hours are from 6.30pm to 8pm on Mondays and Wednesday and Saturday morning. The practice is also open during the lunch period to support patients who work to access the practice during their lunchtime. The practice does not provide an out of hours service to its patients but has alternative arrangements for patients to be seen when the practice is closed. Patients are directed to the out of hours service, NHS111, Primecare and the local Walk-in centre.

The practice has a contract to provide Alternative Provider Medical Services (APMS) for patients. This allows the practice to have a contract with NHS and other non-NHS health care providers to deliver enhanced and primary medical services to meet the needs of the local community. They provide Directed Enhanced Services, such as the childhood vaccination and immunisation scheme and minor surgery. The practice provides a number of clinics for example long-term condition management including asthma, diabetes and high blood pressure.

Updated 1 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Parkfields Wolverhampton Medical Services Ltd. on Monday 15 February 2016. Overall the practice is rated as good.

• 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 the skills, knowledge and experience to deliver effective care and treatment. All staff had received dementia friends training to support meeting the needs of older patients.
• 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.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• 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 the 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 practice maintained a register of vulnerable patients registered at the practice. The register included asylum seekers, patients with language or literacy requirements. The practice had access to translation and interpretation services to ensure patients were involved in decisions about their care.

There was one area where the provider should make improvement:

• Ensure that records of significant events provide sufficient information to show that they are appropriately reviewed and monitored to demonstrate improvement.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 1 June 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. Performance for diabetes assessment and care was higher than the national average (97% compared to the national average of 89%). 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. Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

Updated 1 June 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. The practice’s uptake for the cervical screening programme was 83%, which was comparable to the national average of 82%.

Updated 1 June 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 offered home visits and urgent appointments for those older patients with enhanced needs. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice had a proactive working relationship with four nursing/independent care homes. There was effective communication between the practice and care home staff and visits to the homes were made when requested. Weekly ward rounds were made to patients in two of the four care homes by the advanced nurse practitioner.

Updated 1 June 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 appointment telephone line was open between 8.30am and 6.30pm and extended hours were offered two evenings per week. 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.

Updated 1 June 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The data showed that 87% of patients on the practice register who experienced poor mental health had a comprehensive agreed care plan in the preceding 12 months. This was comparable to the national average of 88%. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. The practice regularly worked with multi-disciplinary teams in the case management of people who experienced poor mental health, including those with dementia. It carried out advance care planning for patients with dementia. The percentage of patients diagnosed with dementia whose care had been reviewed in a face to face review in the preceding 12 months was 90%, which was comparable to the national average of 84%. Staff had a good understanding of how to support people with mental health needs and dementia.

Updated 1 June 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 with a learning disability and carried out annual health checks for these patients. An easy read (pictorial) letter was sent to patients with a learning disability inviting them to attend the practice for their annual health check.

Staff had been trained 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. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told vulnerable patients about how to access various support groups and voluntary organisations.