Archived: Dr Leena Saxena

Updated 13 October 2016

Dr Leena Saxena provides primary care services to its registered list of approximately 3100 patients. The practice is situated and the inspection was conducted at Winstanley medical centre, Wigan.

This is a purpose built GP Surgery with disabled access. There are parking facilities, including disabled spaces, and it is easily accessible by local transport links.

There is one principal GP (female) supported by two long standing locum GPs (one male and one female) and they are supported by a female practice nurse and a female healthcare assistant. There is also a practice manager and supporting administration staff.

The age profile of the practice is very similar to the CCG and national averages. The male life expectancy for the area is 81 years compared with the CCG averages of 77 years and the national average of 79 years. The female life expectancy for the area is 84 years compared with the CCG averages of 81 years and the national average of 83 years. The practice has a higher percentage (71%) of working status (paid work or full-time education) patients compared to the CCG (59%) and national averages (62%).

The practice delivers commissioned services under the General Medical Services (GMS) contract with NHS England and is part of Wigan Clinical Commissioning Group. It offers direct enhanced services for the childhood vaccination and immunisation scheme, facilitating timely diagnosis and support for people with dementia, influenza and pneumococcal immunisations, improving patient online access, learning disabilities, patient participation, minor surgery, rotavirus and shingles immunisation and unplanned admissions.

The practice is open between 8am to 6.30pm on Monday, Thursday and Friday, 8am and 8pm on a Tuesday and from 8am to 1pm on a Wednesday. Routine GP appointments are available each morning from 9am to 11am, and on Monday, Tuesday, Thursday and Friday from 4.30pm to 6pm. There are also appointments available from 6.30pm to 8pm on a Tuesday evening.

Patients requiring a GP outside of normal working hours are advised to contact the surgery and they will be directed to the local out of hour’s service which is provided by Bridgewater NHS Foundation Trust –through NHS 111. Additionally patients can access GP services in the evening and on Saturdays and Sundays through the Wigan GP access alliance at locations across Wigan Borough.

Updated 13 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Leena Saxena on 15 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 been trained to provide them with 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. 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 13 October 2016

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

• The practice nurse supported by the GP had a lead role 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 of these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 13 October 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.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 13 October 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.

Updated 13 October 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.

Updated 13 October 2016

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

• 100% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is higher than the clinical commissioning group (CCG) and national averages.
• 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.

Updated 13 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 living in vulnerable circumstances including those with a learning disability.
• The practice offered longer appointments 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.