Springfields Medical Centre

Updated 29 March 2016

Springfields Medical Centre is located in Bath Street Health & Wellbeing Centre, Legh Street Warrington, Cheshire. The practice provides a service to approximately 6,000 patients. The practice is situated in an area with average levels of deprivation when compared to other practices nationally. The percentage of patients with long standing health conditions is slightly lower than the national average. The percentage of patients with health related problems in daily life is higher than the national average. Unemployment levels are also higher than the national average.

The practice is run by two GP partners and there is an additional salaried GP (3 female). There are four practice nurses, two health care assistants, a practice manager, deputy practice manager and team of reception and administration staff.

The practice is open from 8.00am to 6.30pm Monday to Friday and Saturday from 8.15am to 12.00pm The practice had signed up to providing longer surgery hours as part of the Government agenda to encourage greater patient access to GP services. As a result patients could access a GP at the Health and Wellbeing Centre in which the practice was housed from 6.30pm until 8.00pm Monday to Friday and between 8.00am to 8.00pm Saturdays and Sundays. This was by pre-booked appointment. Outside of practice hours patients can access the Bridgewater Trust for primary medical services.

The practice has a Personal Medical Services (PMS) contract and offers a range of enhanced services for example; childhood vaccination and immunisation, facilitating early diagnosis and support to patients with dementia and health checks for patients who have a learning disability.  

Updated 29 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Springfield Medical Centre on 20 January 2016. Overall the practice is rated as outstanding.

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

• Staff assessed patient’s needs and delivered care in line with current evidence based guidance.

• Staff were well supported in their roles and were kept up to date with training and professional development. They had the skills, knowledge and experience to deliver effective care and treatment.

• Systems were in place to deal with emergencies and all staff were trained in basic life support.

• There were systems in place to reduce risks to patient safety. For example, infection control practices were good and there were regular checks on the environment and on equipment used.

• Patients said they were treated with compassion, dignity and respect.

• Patients felt informed about their health conditions and the treatment options available to them.

• The practice was proactive in identifying and supporting patients to prevent common health conditions.

• Patients found it easy to make an appointment and there was good continuity of care.

• The practice provided a range of enhanced services to meet the needs of the local population.

• The practice had good facilities, including disabled access. It was well equipped to treat patients and meet their needs.

• There was a clear leadership structure and staff understood their roles and responsibilities.

• Information about the services provided and other local support services were made readily available to patients.

• The practice sought patient views about the service and acted upon their feedback.

• Engagement with the Patient Participation Group (PPG) was very strong and the PPG had been involved in an extensive list of activities.

• Complaints were investigated and responded to appropriately.

• Significant events were investigated and action was taken as a result of the learning.

• The practice made good use of audits and the results of these were used to improve outcomes for patients.

• The GPs were knowledgeable of and incorporated local and national objectives and strategies into their work.

Areas where the provider should make improvement:

• The practice should look to improve how they share the learning from significant events and should consider auditing their practices to prevent any re-occurrence of events.

Areas of outstanding practice:

• One of the GP partners had a lead role for cancer within the CCG and this had resulted in greater awareness of the early signs and symptoms of cancer amongst staff at the practice and had been instrumental in the practice's high rate of cancer referrals and in them hosting a range of cancer awareness events.

• GPs were highly commended by patients for their caring and compassionate attitude towards them. The practice provided a flexible and patient centred approach. For example, the GPs provided patients who were receiving end of life care at home, their carers and relevant health professionals, with direct contact numbers so that they could be contacted for advice and support 24 hours per day 7 days per week.

• One of the GPs had received two awards from the Clinical Commissioning Group in 2015 in recognition of their contribution to healthcare within the locality and to innovation in practice.

• A member of staff was designated as a ‘patient co-ordinator’. Their role was to act as a point of contact for advice and support and to assist patients in navigating services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 29 March 2016

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

The practice held information about the prevalence of specific long term conditions within its patient population. This included conditions such as diabetes, chronic obstructive pulmonary disease (COPD), cardio vascular disease and hypertension. The information was used to target service provision, for example to ensure patients who required immunisations received these.

Clinical staff had lead roles in chronic disease management and they had been provided with diploma level training in long term conditions.

Patients with long term conditions attended regular reviews to check that their health and medication needs were being met. Dedicated administrative staff were responsible for maintaining an up to date record of patients who required a review and patients were sent reminders to attend for health checks if they failed to attend their original appointment.

Data from 2014 to 2015 showed that the practice was performing higher than average for the care and treatment of people with chronic health conditions, for example patients with diabetes.

The practice worked proactively to identify patients at risk of developing health conditions and referred /signposted patients for advice and support on preventative care.

Longer appointments and home visits were available when needed. The GPs worked with relevant health and social care professionals to deliver a multidisciplinary package of care to people with more complex needs and those receiving end of life care.

The GPs provided their direct telephone numbers to patients receiving end of life care at home, their carers and relevant health professionals to enable them to contact the GPs at all times for advice and support. The practice worked to avoid unplanned hospital admissions for patients.

Updated 29 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.

Regular meetings were held with a health visitor linked to the practice to share information or concerns about child welfare.

Appointments were available outside of school hours and appointments were provided to children at short notice.

The premises were suitable for children and babies and baby changing facilities were provided.

Child immunisation rates were comparable with local Clinical Commissioning Group benchmarking for standard childhood immunisations. Immunisations could be provided without a pre-booked appointment to encourage uptake. The practice monitored non-attendance of babies and children at vaccination clinics and staff told us they would report any concerns they had identified to relevant professionals.

The practice hosted a breast feeding clinic to promote breast feeding and support patients in this.

The staff we spoke with had appropriate knowledge about child protection and they had ready access to safeguarding policies and procedures.

Updated 29 March 2016

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

The practice offered proactive and personalised care and treatment to meet the needs of the older people in its population.

Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice kept up to date registers of patients with a range of health conditions and used this information to plan reviews of health care. Home visits and urgent appointments were provided for those patients with enhanced needs.

The practice used the ‘Gold Standard Framework’ (this is a systematic evidence based approach to improving the support and palliative care of patients nearing the end of their life) to ensure patients received appropriate care. GPs attended multi-disciplinary meetings to review the care and treatment provided to people who were receiving end of life care and to prevent unplanned hospital admissions.  

Updated 29 March 2016

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

The practice offered electronic prescribing and an online appointment services which provided flexibility to working patients and those in full time education.

Telephone consultations were available every day through the ‘Doctor first’ appointment system. The practice was open on Saturday mornings to accommodate working patients and the practice was part of a cluster of practices whose patients could access appointments at a local Health and Wellbeing Centre up until 8pm in the evenings Monday to Friday, and from 8.00am to 8.00pm Saturdays and Sundays, through a pre-booked appointment system. The GPs also contacted working patients outside of practice opening hours if they required this.

Feedback from patients about matters such as; accessing the practice, making appointments and opening times was consistently higher than local and national averages.

The practice provided an enhanced service allowing patients who lived out of area to register at the practice if they worked in the area.

A range of health promotion and screening that reflected the needs for this age group was available to patients.

The practice website provided a good range of information about the practice and the services offered and provided advice on common health conditions and preventative care.

Updated 29 March 2016

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

Data about how people with mental health needs were supported showed that outcomes for patients using this practice were above average compared to national data. For example, the percentage of patients diagnosed with dementia who had had their care reviewed in a face to face meeting in the last 12 months was higher than the national average.

The practice provided an enhanced service for screening patients to identify patients at risk of dementia and to develop care plans with them. The GPs carried out cognitive assessments with patients and referred patients to a memory clinic if this was appropriate.

Staff were knowledgeable with regards to consent and supporting patients to obtain consent.

Patients with poor mental health were given extended appointments.

Patients experiencing poor mental health were provided with information about how to access support groups and voluntary organisations.

Processes were in place to prompt patients for medicines reviews at intervals suitable to the medication they took and patients who did not attend were sent follow up reminders.

The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

Updated 29 March 2016

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

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.

The practice held a register of patients living in vulnerable circumstances and they used this information to tailor the service provided. For example, longer appointments and annual health checks were provided for people with a learning disability.

The GPs used assessment tools to assess patients’ cognitive ability when this was required and care planning was carried out for patients living with dementia.

One of the GPs took the lead for drug misuse within the practice and they had received training for this. The practice hosted a weekly drug misuse clinic.

Information and advice was available about how to access a range of support groups and voluntary organisations. The Citizens Advice Bureau provided regular sessions to provide advice to patients.

The practice worked with multi-disciplinary teams in the case management of vulnerable people when required.