Wychbury Medical Group

Updated 3 October 2016

Wychybury medical Group is a long established practice located in the area of Dudley, in the West Midlands. There are three practice locations that form the practice; these consist of the main practice at Wychbury Medical Centre in Stourbridge and two branch practices at Cradley Road surgery in Cradley Heath and Chapel House surgery in Halesowen. During the inspection we visited Wychbury Medical Centre and the branch practice at Cradley Road surgery.

There are approximately 21,500 patients of various ages registered and cared for across the practice and as the practice has one patient list. Patients can be seen by staff at all surgery sites and systems and processes are shared across the three sites. Services to patients are provided under a General Medical Services (GMS) contract with NHS England. The practice has expanded its contracted obligations to provide enhanced services to patients. An enhanced service is above the contractual requirement of the practice and is commissioned to improve the range of services available to patients.

The clinical team includes eight GP partners (four male and four female), five salaried GPs, four advanced nurse practitioners including a clinical nurse manager, six practice nurses and two health care assistants. The GP partners, clinical nurse manager and the practice manager form the senior management team and they are supported by an assistant practice manager, three reception managers and a personal assistant. There is a team of 60 support staff who cover reception, secretarial and administration roles. The practice is also an approved training practice and provids training to medical and nurse students from the Birmingham University.

Wychbury Medical Centre and Cradley Road branch surgery are open between 8am and 6:30pm during weekdays. Appointments are available at these sites from 8:30am to 6:30pm. Extended hours are available from 7am on Tuesdays and Thursdays at Wychbury Medical Centre and until 8pm on Wednesdays at Cradley Road branch surgery.

Chapel House branch surgery is open between 8am and 6pm on Mondays, Wednesdays and Fridays; on Tuesdays and Thursdays this surgery closed at 1pm. Appointments are available from 8:30am to 5:30pm on Mondays, Wednesdays and Fridays and from 8:30am and 12:30pm on Tuesdays and Thursdays.

On Tuesday and Thursday afternoons when Chapel House branch surgery is closed, patients can be seen at either Wychbury Medical Centre or Cradley Road branch surgery. There are also arrangements to ensure patients received urgent medical assistance when the practice is closed during the out-of-hours period.

Updated 3 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Wychbury on 16 August 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• Governance and performance management arrangements were well managed and proactively reviewed to reflect best practice. The practice was proactive in identifying and managing significant events. All opportunities for learning from internal and external incidents were maximised.

• Risks to patients were assessed and well managed. Patients’ needs were assessed and care was planned and delivered following best practice guidance. The practice had clearly defined and embedded systems, processes and practices in place to keep people safe and safeguarded from abuse.

• There was a structured programme of continuous clinical and internal audit which were often initiated as a result of national patient safety alerts, significant events and incidents.

• The practice team was forward thinking and was involved in a number of clinical research studies and proactively engaged in local projects and initiatives. In addition to clinical projects the practice was exploring the use of modern technology to streamline administration tasks.

• There was a strong multidisciplinary approach to patient care. The team met frequently and engaged well with other services through a programme of multidisciplinary team (MDT) meetings, admission avoidance meetings and had also formed specific psychiatry and paediatric MDT meetings.

• Patients could access appointments and services in a way and at a time that suited them. Patients were given the option of a preferred practice location and they could also access services across the three sites including cervical screening, minor surgery and phlebotomy.

• The practice offered a choice of extended hours at two of their practice sites to suit their working age population. Additionally, one of the GPs operated a morning and afternoon telephone triage service and rotated around the three practice sites for patients who needed to be seen urgently.

• We observed the premises for the Wychbury Medical Centre to be visibly clean and tidy. We found that some areas of the Cradley Road branch surgery were moderately run down however there were plans in place to refurbish the premises which were due to start within the next three months

• The practice had a large patient participation group (PPG) consisting of 202 members which influenced practice development and was actively promoting the Pharmacy First Scheme in the local area.

• Notices in the patient waiting room told patients how to access a number of support groups and organisations. There was also a practice library in place for patients to borrow books on a wide range of health topics.

• We saw that staff were friendly and helpful and treated patients with kindness and respect. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• Staff spoken with demonstrated a commitment to providing a high quality service to patients.

We saw an area of outstanding practice:

• The practice operated a number of out-reach services including a consultant led Uro-gynaecology clinic. Practice data highlighted active use of the service which provided convenience for patients and effective referrals to secondary care.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 October 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 overall diabetes related indicators was 99%, compared to the CCG average of 89% and the national average of 90%.

• We saw evidence that multi-disciplinary team meetings took place on a monthly basis with regular representation from other health and social care services. We saw that discussions took place to understand and meet the range and complexity of people’s needs and to assess and plan ongoing care and treatment.
• The percentage of patients with hypertension having regular blood pressure tests was 100%, with an exception rate of 4%.

Updated 3 October 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.

• Childhood immunisation rates for under two year olds ranged from 83% to 98% compared to the CCG averages which ranged from 83% to 98%. Immunisation rates for five year olds were ranged from 95% to 100% compared to the CCG average of 93% to 98%.

• The practice offered urgent access appointments were available for children, as well as those with serious medical conditions.
• We saw minutes of meetings to support that the practice worked closely with the Health Visitors and Midwife.

Updated 3 October 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.

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

• The practice had effective systems in place to identify and assess patients who were at high risk of admission to hospital. Patients who were at risk of admission to hospital and patients who had been discharged from hospital were reviewed on a monthly basis as part of the practices monthly admissions avoidance meetings involving regular representation from other health and social care services.

• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• Immunisations such as flu and shingles vaccines were also offered to patients at home, who could not attend the surgery.

Updated 3 October 2016

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

• Patients could access appointments and services in a way and at a time that suited them.

Appointments could be booked over the telephone, face to face and online.

• The practice offered a choice of extended hours to suit their working age population, with early appointments available at Wychbury Medical Centre two days a week and later appointments available one day a week at Cradley Road Surgery.

• The practice was proactive in offering a full range of health promotion and screening that reflects the needs for this age group.
• Practice data highlighted that 1034 patients had been identified as needing smoking cessation advice and support; all of these patients had been given advice within the last 12 months and 40% of these patients had successfully stopped smoking.

Updated 3 October 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 other health and social care organisations in the case management of people experiencing poor mental health, including those with dementia.

• Performance for mental health related indicators was 100%, with an exception rate of 11%. These patients were regularly reviewed and further reviews were planned.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• There were 183 patients on the practices register for dementia. Data showed that appropriate diagnosis rates for patients identified with dementia were at 100%.

Updated 3 October 2016

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

• There were 85 patients on the practices learning disability register, 97% of these patients had received a medication review in a 12 month period.

• The practice regularly worked with other health and social care organisations in the case management of vulnerable people. It had told vulnerable patients about how to access various support groups and voluntary organisations.

• The practice had 167 patients on their palliative care register. We saw that the practices palliative care was regularly reviewed and discussed as part of the MDT, GSF and admission avoidance meetings to support the needs of patients and their families.
• The practice had identified 158 patients with drug and alcohol dependencies, these were included in the practice register for vulnerable patients. Practice data highlighted that 85% of these patients received medication reviews within a 12 month period.