Middlestown Medical Centre Also known as Dr Swan and Partners

Updated 16 March 2016

Middlestown Medical Centre operates from a purpose built medical centre located in Wakefield. The practice also has two branch sites located in Flockton and Emley. We visited all three sites as part of our inspection. Patients can access services at all three sites.

Services are provided under a personal medical services contract. This is the contract held between the practice and NHS Commissioners.

The practice serves a population of approximately 7860 patients and the service is provided by four GP partners (two male and two female). The partners are supported by two female salaried GPs, three GP Registrars, an advanced nurse practitioner, three practice nurses, a health care assistant and a phlebotomist. The clinical staff are supported by an experienced team of administration and reception staff.

Patients can access a number of clinics for example; minor surgery, asthma and diabetes and the practice offers services such as antenatal and postnatal care, childhood vaccinations and well-person check-ups.

Middlestown Medical Centre is open between 8am - 6.30pm Monday to Friday and 8am - 12pm on Saturdays.

Emley Surgery is open between 9am – 10.30am and 4pm to 6pm on Mondays and Wednesdays, from 9am – 10.30am on Tuesday and from 4pm to 6pm on Fridays.

The Flockton Surgery is open between 11am – 12.30pm Monday to Thursday.

Registered patients can also access appointments through the West Wakefield Extended Hours service which provides pre-bookable appointments from 6.30pm – 8pm Monday to Friday and 8am to 8pm on Saturday and Sundays.

Updated 16 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Middlestown Medical Centre on 22 September 2015. Overall the practice is rated as good.

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 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.
• 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 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 one area of outstanding practice:

• Following feedback from patients the practice offered extended hours every Saturday morning and a late night session with the practice nurse and HCA every two weeks to accommodate patients who could not attend surgery during normal hours. This was funded by the practice.

The areas where the provider should make improvement are:

• During our inspection we identified an issue with recording fridge temperatures and saw that these had been manually recorded out of range over a period of time. We addressed this with the practice manager on the day of our inspection.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 16 March 2016

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

• The practice held a register of patients with long term conditions such as diabetes, COPD, and heart disease.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• 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 multi-disciplinary package of care.

Updated 16 March 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.
• The practice had a recall system to ensure regular smears were carried out on women aged between 24 and 65 years of age.
• Sexual health and contraception were discussed opportunistically and patients aged between 15 and 24 years were encouraged to have a chlamydia testing as appropriate.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 16 March 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.
• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• All patients over the age of 75 had a named GP.
• The practice provided facilities and services to deal with all needs, working collaboratively with an integrated team to ensure patients received the physical, social and psychological support required.
• The practice nursing team offered a flexible approach to housebound patients in cases where complex needs required specialist nursing skills and visited these patients at home.
• Practice nurse home visits were allocated at times convenient for the patient.

Updated 16 March 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 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.
• The practice provided a clinican call back service to patients that were unable to access the surgery during normal hours.
• Following feedback from patients the practice offered extended hours every Saturday morning and a late night session with the practice nurse and HCA every two weeks to accommodate patients who could not attend surgery during normal hours. This was funded by the practice.
• In addition to the above, the practice were part of Network6. Network 6 was a group of practices in the local area who worked together to provide additional services in the locality. This enabled patients to access late night session from 6.30pm to 8pm every evening and from 8am to 8pm at the weekend.
• The practice offered repeat dispensing for patients with controlled medical conditions.

Updated 16 March 2016

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

• 90.6% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months.
• The practice regularly worked with multidisciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• It 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.
• It 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 people with mental health needs and dementia.

Updated 16 March 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.
• It offered longer appointments for people with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• The practice were part of the Safer Places Scheme and were awaiting training to become a Dementia Friendly Practice.
• It had told 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.