Archived: Bilston Urban Village Medical Centre Also known as IntraHealth Limited

Updated 10 July 2017

Bilston Urban Village Medical Centre is one of two GP practices in Wolverhampton owned by Intrahealth, a corporate provider of NHS primary care services. The premises are a single storey building. All areas are easily accessible by patients with mobility difficulties and families with pushchairs or prams.

The practice team consists of two medical directors who also undertake sessions as GPs at the practice, four GPs (four male and two female), who work across the two of the Intrahealth practices based in Wolverhampton. The practice also uses regular GP locums to support the clinicians and meet the needs of patients at the practice. The clinical practice team includes two clinical pharmacists, an advanced clinical practitioner, three nurse practitioners, two practice nurses, a healthcare assistant and a phlebotomist. The clinical pharmacists and nursing staff also work over both sites. Practice staff include a practice manager, reception manager and six administration/ receptionist support staff. In total there are 24 staff employed either full or part time hours to meet the needs of patients. The practice is a training practice for GP trainees.

The practice is open between 8am to 8pm on a Monday to Friday and 8am to 12pm on Saturdays. 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 provided by Vocare via the NHS 111 service.

The practice has a contract to provide Alternative Provider Medical Services (APMS) to approximately 6,200 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 new patients’ health checks. The practice provides a number of clinics for example long-term condition management including asthma and diabetes.

The practice has a significantly higher young population compared to the average across England. There is a high number of patients aged nine and below, female patients aged 20 to 24 years and patients between the ages of 25 to 39 years. The practice is located in one of the most deprived areas of Wolverhampton. People living in more deprived areas tend to have a greater need for health services. There is a higher 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 37% is higher than the national average of 20%. The level of income deprivation affecting older people is higher than the national average (32% compared to 16%).

Updated 10 July 2017

Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection at Bilston Urban Village Medical Centre on 1 July 2016. After the comprehensive inspection, the practice was rated as requires improvement for providing well led services.

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

This inspection was an announced focused inspection carried out on 31 May 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified at our previous inspection on 1 July 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection

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

• The practice had reviewed their processes for reporting, recording significant events and monitoring any changes made.
• The practice had reviewed its data protection and confidentiality policies and procedures to ensure they were aligned to relevant guidance. A folder with guidance on the length of time different types of information should be kept before they were destroyed was available to staff.
• Systems to effectively manage safety alerts had been implemented. For example, we saw copies of recent medicine alerts the practice had received with appropriate records to confirm the alerts had been reviewed and appropriate action taken.
• Systems had been put in place for checking the ongoing accuracy of the temperature of fridges used to store medicines. The changes made ensured that medicines requiring refrigeration were stored in line with the manufacturer’s guidance.
• The practice had pro-actively identified a further 35 carers and had arrangements in place to ensure carers had ease of access to the support they need.
• The provider was aware of and complied with the requirements of the duty of candour.

At this inspection we found that the practice had addressed all the concerns raised and is now rated as good for providing well-led services.

There was one area of practice where the provider should still make improvements:

• Continue to make improvements to proactively identify carers and establish support they need.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 October 2016

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

• The GPs, nurses and healthcare assistants had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• 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 higher overall compared to the local and national average. For example the practice performance for diabetes related clinical indicators overall was higher than the local Clinical Commissioning Group and England average (95% compared to the local average of 82% and England average of 89%).
• Longer appointments and home visits were available when needed.

Updated 19 October 2016

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

• 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.
• Babies were given their first immunisations on the same day as mothers were offered their six week postnatal check.
• The practice’s uptake for the cervical screening programme was 79% which was comparable to the local Clinical Commissioning Group (CCG) average of 78% and England average of 82%.
• Protected daily appointments were available for children of all ages and children aged under the age of one were given priority and seen on the day. Appointments were available outside of school hours and urgent appointments were available for children.
• We saw positive examples of joint working with other professionals.

Updated 19 October 2016

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 for those with enhanced needs plus longer appointments which gave them more time to discuss health issues with a clinician.

Updated 19 October 2016

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

• The practice offered on telephone consultations specifically for workers.
• Extended hours appointments were available each weekday between the hours of 8am and 8pm and on Saturday from 8am to 12 mid-day.
• The practice was proactive in offering online services which included making online prescription and appointment requests.
• Patients were sent telephone texts to remind them about their appointment and to send test results.
• Patients were signposted to a full range of health promotion and screening that reflects the needs for this age group.

Updated 19 October 2016

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 96% 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. Counselling clinic sessions were held at the practice with an experienced mental health counsellor based in the community.
• The percentage of patients diagnosed with dementia whose care had been reviewed in a face to face review in the preceding 12 months was 86%, which was higher than the national average of 84%.

Updated 19 October 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 offered this group of patients longer appointments.
• 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 supported patients who were identified as being homeless and provided both health and social professional support.
• 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.