Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Watling Medical Centre on 28 July 2016. Watling Medical Centre comprises a main location based in Burnt Oak, London Borough of Barnet and a branch location (approximately four kilometres away) based in Stanmore, London Borough of Harrow. Overall the practice is rated as good.
Our key findings across all the areas we inspected were as follows:
- 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 several areas of outstanding practice. For example:
In 2014, the practice successfully applied for external funding to provide a Wellbeing Service to support patients’ social needs in Burnt Oak; an area of high social deprivation. The service employs a navigator to map services (including community and voluntary services) across the local area and navigate patients to the right local organisation for support.
The service also supports vulnerable groups such as the frail elderly and vulnerable young families in areas such as benefit maximisation support for carers; social isolation, bereavement support and employment support. A community fair event had also been organised to raise awareness of relevant services and individuals amongst vulnerable local families.
Since February 2014, all patients over 16 years of age who have registered with the practice are asked to complete a mental wellbeing assessment based on the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). A protocol is in place to ensure that scores are coded on the practice’s clinical systems and the nursing team are trained to implement support based on individual scores. Clinicians spoke positively about the impact of the service on reducing the amount of time spent dealing with social issues. For example:
Between February 2014 and January 2016 1,368 patients completed the WEMWBS assessment 20% of whom had been directly referred to the Well Being service. The remaining 80% were supported by the nursing team with general wellbeing advice during the new patient health check.
In addition, between February 2014 and January 2016, 241 patients were referred to voluntary sector organisations. Reasons for referral included childcare support, immigration support, support for carers, social isolation, and bereavement support.
In March 2016, the practice introduced a health champion programme designed to motivate, empower and support patients to make healthier lifestyle choices and signpost them to relevant services/organisations. The health champion programme is the first of its kind in Barnet and one of the first nationally which is a partnership with a community organisation.
Feedback from clinicians has been positive; with many feeling that the health champions provide a valuable service within the practice which has reduced the number of patients asking for their advice about social issues. Reception staff and clinicians routinely signpost patients to health champions for advice/support. To date the programme has achieved:
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Eight volunteers trained and received an Introduction to Health Improvement Award through the Royal Society for Public Health.
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Two health champions volunteering at the practice two hours per week; signposting individuals to relevant services and supporting patients writing letters (for example to housing services).
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One Stroke champion peer support worker supporting individuals and their families/carers who have suffered a stroke.
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One hundred and forty eight patient contacts. These patients have been signposted to services such as housing advice, financial support, employment advice, carers support and smoking cessation.
The areas where the provider must make improvements are:
The areas where the provider should make improvement are:
- Review systems in place for identifying and supporting carers.
- Review systems in place for ensuring the safe storage of vaccines.
- Consider how the practice’s cervical screening uptake rate can be increased.
- Ensure that all non clinical staff receive annual basic life support training.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice