Archived: Wilderness Road Surgery

Updated 17 December 2015

This inspection was carried out at the Wilderness Road Surgery which is based in a converted residential dwelling. It has been operating from this location since 1981.

The family run practice offers GP services to the local community of Earley and Woodley on the outskirts of Reading, Berkshire.

Wilderness Road Surgery is one of 13 practices within Wokingham Clinical Commissioning Group.

The practice has core opening hours from 8.00am to 6.30pm Monday to Friday to enable patients to contact the practice. The practice remains open every Monday and Friday evening until 7.30pm. Appointments can be booked in advance for the doctors and for the nursing clinics.

There are approximately 2,000 patients registered with the practice. The practice has a transient patient population; patients are often outside of the country for long periods. This has an impact on screening and recall programmes.

According to national data there is minimal deprivation in the area.

The practice comprises of two GP partners (both male GPs) who are supported by one long term locum GP (a female GP). The long term locum also has additional management duties within the practice.

The practice has one nurse with a mix of skills and experience. A long term locum GP and a team of seven administrative staff undertake the day to day management and running of the practice. The practice has a General Medical Services (GMS) contract. GMS contracts are nationally agreed between the General Medical Council and NHS England.

The practice opted out of providing the out-of-hours service. This service is provided by the out-of-hours service accessed via the NHS 111 service. Advice on how to access the out-of-hours service is clearly displayed on the practice website and over the telephone when the surgery is closed.

Wilderness Road Surgery is registered to provide services from the following location:

Wilderness Road Surgery

Earley

Reading

Berkshire

RG6 7RU

Updated 17 December 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Wilderness Road Surgery on 4 November 2015. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.

• 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 implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the Patient Participation Group (PPG).

• The practice had an effective governance system in place, was well organised and actively sought to learn from performance data, incidents and feedback.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 17 December 2015

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

• The GPs and practice nurse had the knowledge, skills and competency to respond to the needs of patients with long term conditions such as asthma and COPD (Chronic obstructive pulmonary disease is the name for the collect of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease). 

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

• Patients with end of life care needs and their families were well supported by the practice.

Historic quality data demonstrated the monitoring of patients with long term conditions, for example diabetes, compared better than the national average. For example:

• 93.1% of patients with diabetes, on the register, had a blood pressure reading (measured in the preceding 12 months) is 140/80 mmHg or less. This is higher when compared to the national average of 78.5%.

• 94.3% of patients on the diabetes register had a record of a foot examination and risk classification within the preceding 12 months. This is higher when compared to the national average of 88.4%.

Updated 17 December 2015

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 for standard childhood immunisations were comparable with the local CCG average. Specific data for childhood immunisation rates for the vaccinations given in 2014/15 to under one year olds (meningitis C, pneumococcal conjugate vaccine, diphtheria, tetanus, pertussis, polio and Haemophilus influenza type b.) was 100%. This was significantly higher than the local average, ranging between 93.4%-95.5%.

• 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 provided sexual health information and were proactive and opportunistic in screening for chlamydia.

• The practice’s performance for the cervical screening programme was 80%, which was higher when compared to the CCG average of 78.3% and the national average of 74.3%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 17 December 2015

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

• The practice provided person centred care to meet the needs of the older patients in its population and had a range of enhanced services, for example in dementia, end of life care and reducing admissions to hospital.

• Unplanned hospital admissions and re-admissions for this group were regularly reviewed and improvements made.

• It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

• The practice identified if patients were also carers; information about support groups was available in the waiting room. Support groups information included Wokingham Borough Council “Home Library Service”.

Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people, for example, data showed the percentage of patients with atrial fibrillation and are currently treated with anticoagulation drug therapy or an antiplatelet therapy was 100%. This was 2% higher than the national average.

Updated 17 December 2015

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 provided a range of appointments between 8am and 6.30pm Monday to Friday with the exception of Wednesdays. The practice closes at 1pm on Wednesday; a GP remains in the practice and manages the emergency telephone line. The practice had extended hours 6.30pm-7.30pm on Mondays and Fridays. These were specifically for patients not able to attend outside normal working hours.

• The practice had re-launched their website and we saw plans to offer online services as well as a full range of health promotion and screening that reflects the needs for this age group.

• Health promotion advice including up to date health promotion material was available through the practice.

Updated 17 December 2015

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. It carried out advance care planning including regular face-to-face reviews for these patients. For example:

• 100% of patients diagnosed with dementia had their care reviewed in a face-to-face review; this was 17% higher than the national average.

• 100% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record; this was 14% higher than the national average.

• 100% of patients with schizophrenia, bipolar affective disorder and other psychoses have had their alcohol consumption recorded; this was 12% higher than the national average.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. Support group information for example Wokingham Borough Council “Home Library Service” included information about reminiscence and “Forget Me Not” boxes (a known supportive mechanism for people with memory loss and dementia).

Updated 17 December 2015

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

• The practice held a register of vulnerable patients including those with a learning disability. We saw the practice had carried out annual health checks for people with a learning disability and these patients had a personalised care plan in place.

• We saw longer appointments (20 minutes) were available for patients that needed them.

• Vulnerable patients were told 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.