Whitnash Medical Centre

Updated 14 December 2016

Drs Holtby & Martin (also known locally as Whitnash Medical Centre) is a purpose built premises located in Whitnash close to Leamington Spa within the NHS South Warwickshire Clinical Commissioning Group (CCG). The practice is served by the local bus network with a bus stop directly outside the practice. There is accessible parking immediately outside. The practice and facilities are fully accessible to wheelchair users.

The practice provides primary medical services to approximately 5,700 patients in the local area. The patient group is mostly white British with a significant Asian and Asian British population.

The clinical staff team consists of two female and one male GP partners, a female salaried GP and two practice nurses. There are three staff who combine health care assistant, phlebotomy and receptionist roles.

Drs Holtby & Martin is an approved training practice for trainee GPs. A trainee GP is a qualified doctor who is training to become a GP through a period of working and training in a practice. There are currently two GP trainees working at the practice. The practice also offers placements to medical students from Warwick Medical School

The clinical team is supported by a practice manager, a practice manager’s assistant, a business manager, and six administrative/reception staff (in addition to the three above). There is also an apprentice working in collaboration with Warwickshire College and two cleaners employed by the practice.

The practice and telephone lines are open from 8.30am to 6pm on weekdays, and offers extended hours clinics on Thursday evenings (from 6.30pm to 7.30pm) and alternate Saturday mornings (from 8am to 10am).

When the practice is closed between 8am and 8.30am and 6pm and 6.30pm on weekdays services are provided by the West Midlands Ambulance Service who will contact one of the practice GPs (who acts in a duty doctor capacity during these times) if required. Patients are directed to this number by the practice website, information leaflets and a recorded message on the practice telephone system.

Further out of hours services are provided by the NHS 111 service.

Updated 14 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Drs Holtby & Martin (also known locally as Whitnash Medical Centre) on 27 September 2016. 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 received training to provide them with the skills, knowledge and experience to deliver effective care and treatment.

• Feedback from patients about their care was consistently positive. 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. Improvements were made to the quality of care as a result of complaints and concerns.

• Patients said they found it easy to make an appointment with a named GP and 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 14 December 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.

• Chronic disease reviews were carried out by nursing staff at the practice or patients’ homes.

• Longer appointments and home visits were available when needed.

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

• The named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care for patients with complex needs.

Updated 14 December 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 accident and emergency attendances. Immunisation rates were high for all standard childhood immunisations.

• GPs performed child health surveillance and post-natal checks and a midwife attended the practice weekly to see patients.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals.

• Performance for cervical screening indicators was in line with Clinical Commissioning Group (CCG) and national averages. For example the percentage of women aged 25-64 who attended for a cervical screening test in the last five years was 84% compared with CCG and national averages of 83% and 82% respectively.

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

• We saw positive examples of engagement and joint working with midwives, health visitors and school nurses.

Updated 14 December 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.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• The practice participated in a local over 75s project offering different levels of reviews working in collaboration with Age UK. The practice offered health checks to all patients aged over 75 in the last 12 months and over 80% of the patients in this age group received these.

• The practice directed older people to appropriate support services.

• All patients aged over 75 had a named GP.

Updated 14 December 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 reflected the needs for this age group.

• The practice offered online appointment booking and the facility to request repeat prescriptions online.

• Appointments were offered to accommodate those unable to attend during normal working hours.

Updated 14 December 2016

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

• Performance for mental health related indicators was in line with the Clinical Commissioning Group (CCG) and national averages. For example, the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the last 12 months was 92% compared with CCG and national averages of 93% and 88% respectively.

• The practice had carried out health checks for all patients registered as having a mental health condition in the last 12 months (42 patients).

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

• The practice 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.

• The practice 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 patients with mental health needs and dementia.

• One of the PPG members with knowledge of dementia had, with the practice’s support, run a dementia education evening at the practice to provide an insight into the condition.

Updated 14 December 2016

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

• The practice had up-to-date registers of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability.

• The practice had traveller families registered as patients and offered to register their postal address at the surgery to help them to access hospital care. Practice staff tried to ensure they had current mobile telephone numbers for these patients.

• The practice had 21 patients registered as having a learning disability and had completed health checks for all of these patients in the last 12 months. The practice offered longer appointments for patients with a learning disability.

• The practice’s computer system alerted GPs if a patient was also a carer. The practice had identified 65 patients as carers, which represented 1% of the total practice population.

• Carers were identified and supported as part of the annual reviews provided for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed 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.

• One of the PPG members with knowledge of dementia had, with the practice’s support, run a dementia education evening at the practice to provide an insight into the condition. This event was promoted in the community magazine and staff and patients told us it had been a real success.