Woodway Medical Centre

Updated 5 December 2017

Woodway Medical Centre is a practice on the outskirts of Coventry. It operates under a General Medical Services (GMS) contract with NHS England. A GMS contract is one type of contract between general practices and NHS England for delivering primary care services to local communities. The practice operates from premises which were purpose built in 1986 and offer accessible facilities for patients with disabilities. The practice was previously the branch surgery of a larger practice which it separated from in 2003.

Woodway Medical Centre has a current patient list size of 5,068 including a number of patients who live in two local care homes. The patient population demographics attending Woodway Medical Centre are broadly in line with national averages, with an above average number aged 45 to 60. Levels of social deprivation are slightly higher than average. The practice has expanded its contracted obligations to provide enhanced services to patients. An enhanced service is above the contractual requirement of the practice and is commissioned to improve the range of services available to patients. For example, the practice offers minor surgery, extended hours access and improved services for patients with dementia.

The clinical team includes two male GP partners, one male salaried GP and one female practice nurse. The team is supported by a practice manager and four administrative staff.

Woodway Medical Centre opens from 8.30am to 12.30pm from Monday to Friday and from 2pm to 6.30pm on Monday, Tuesday, Wednesday and Friday. On Thursday afternoons the practice is open from 2pm to 4.30pm. The practice can be contacted by telephone from 8am, at which time there is always a GP on the premises in case of emergency. Appointments are held from 8.45am until 11.15am from Monday to Friday, and from 3pm until 5.30pm on Monday Tuesday, Wednesday and Friday.

Extended hours appointments are also pre-bookable on Saturday mornings from 8am until 9.45am. When the practice is closed for short periods between 9am and 6.30pm the telephones are redirected to West Midlands Ambulance Service. There are further arrangements in place to direct patients to out-of-hours services provided by NHS 111 when the practice is closed from 6.30pm until 8am and on weekends.

Updated 5 December 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Woodway Medical Centre on 20 January 2017. As a result of our inspection the practice was rated as good overall but required improvement for providing safe services. The full comprehensive report on the January 2017 inspection can be found by selecting the ‘all reports’ link for Woodway Medical Centre on our website at www.cqc.org.uk.

This inspection was a desk-based focused inspection carried out on 30 October 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulations that we identified at our previous inspection on 20 January 2017. This report covers our findings in relation to those requirements.

Overall the practice is rated as good.

Our key findings were as follows:

• Staffing arrangements had been reviewed to ensure patients had adequate access to a female GP when required. The practice told us they had no current GP vacancies to enable recruitment of a female GP. They had however, promoted alternative arrangements in reception. Patients had access to a female locum GP who provided regular sessions at the practice. Female GPs were also available at other local practices for patients who expressed a preference.

• Measures had been put in place to ensure infection control audits were completed and repeated at regular intervals.

• Health and safety risk assessments for the premises had been completed with processes that ensured they were maintained.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 27 April 2017

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

• Performance for diabetes related indicators was higher than local and national averages. For example:

• 88% of patients had a blood glucose measurement within the target range in the previous 12 months, higher than the Clinical Commissioning Group (CCG) average of 79% and the national average of 78%.
• 88% of patients with diabetes had a blood pressure reading within the acceptable range, compared with the CCG average of 77% and the national average of 78%.
• 90% of patients with diabetes had a most recent cholesterol measurement within an acceptable range, again higher than the CCG and national averages which were both 80%.

• The GP partners explained that the practice had a long standing structured programme of diabetic care. Local data showed that the practice was the highest performing in the CCG area for the percentage of patients achieving all three National Institute for Health and Care Excellence (NICE) recommended diabetes treatment standards (monitoring of blood glucose, blood pressure and cholesterol) in 2015/2016. It was also the third highest performing for the percentage of patients receiving all eight NICE recommended care processes in 2015/2016.
• Of the patients on the practices asthma register, 87% had had a review and an assessment of asthma control in the previous year, higher than the CCG average of 77% and the national average of 76%. Exception reporting was 0%, compared with the CCG average of 4% and the national average of 8%.
• The practice also had a higher than average Quality Outcomes Framework (QOF) achievements for treating patients with Atrial Fibrillation (an irregular heart rhythm) and hypertension (high blood pressure).
• The practice maintained registers of patients with long-term conditions and used these to monitor their health and ensure they were offered appropriate services.
• The clinical team had lead roles in chronic disease management.
• We checked a sample of records which showed that patients who were prescribed high risk medicines had been properly monitored. These medicines require frequent blood tests to ensure they remain safe to prescribe.
• The practice offered longer appointments and health checks for patients with long term conditions.
• Clinical staff engaged with healthcare professionals to provide a multidisciplinary package of care.

Updated 27 April 2017

The practice is rated as good for the care of families, children and young people.

• Immunisation rates were higher than the national average for all standard childhood immunisations.
• Same day appointments were available for children.
• Staff told us that children and young people were treated in an age-appropriate way and were recognised as individuals. Clinical staff demonstrated their understanding of Gillick competence and Fraser guidelines, and why these needed to be considered when providing care and treatment to young patients under 16. The Gillick test is used to help assess whether a child has the maturity to make their own decisions and to understand the implications of those decisions. Fraser guidelines related specifically to contraception, sexual health advice and treatment.
• The practice’s patient uptake of cervical screening was in line with national averages.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice leaflet included information about specific appointments for teenagers, childhood immunisations and child health checks, sexual health and ante-natal clinics.

Updated 27 April 2017

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

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice supported older patients who lived in one local care home, which described the service the practice provided as good. We were told that the GPs were responsive to requests for visits and offered continuity of care.
• The practice encouraged older patients to take up flu, pneumonia and shingles vaccinations.
• All correspondence for older people was provided in a large font size for ease of reading.
• The practice coordinated with a multidisciplinary team to care for older people. For example, palliative care meetings were held regularly and included the community matron. Clinicians also maintained direct contact with district nurses.
• Patients aged over 75 were able to access an NHS health check through the practice.

Updated 27 April 2017

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

• Extended hours appointments were pre-bookable on Saturday mornings from 8am until 9.45am for patients who could not attend during working hours.
• Patients could access online services such as repeat prescription ordering and appointment booking.
• A full range of health promotion and screening was available, including NHS health checks for those aged 40 to 74.
• The practice offered services including sexual health, weight management and smoking cessation.

Updated 27 April 2017

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

• Performance for mental health care planning was comparable with local and national averages. For example:

• 71% of patients experiencing poor mental health had a comprehensive agreed care plan documented in their records, which was lower than the CCG average of 86% and the national average of 89%. Exception reporting was 0%, significantly lower than the CCG average of 10% and the national average of 13%.
• 72% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was lower than the CCG average of 81% and the national average of 84%. Exception reporting was 0% for this indicator, again significantly lower than the CCG average of 6% and the national average which was 7%.

• We discussed care planning for mental health patients with the GP partners who were aware that performance data was below average and told us they were trying to improve in this area.
• The practice liaised with multi-disciplinary teams in the management of patients experiencing poor mental health.
• The practice maintained a mental health register which it used to monitor patients and offer relevant information and services.

Updated 27 April 2017

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

• The practice held registers of patients living in vulnerable circumstances including those with a learning disability and patients at high risk of hospital admission.
• Patients with a learning disability were able to access longer appointments.
• The practice had a small number of adolescent patients with mulitple disabilities living in one local care home. Staff at the care home told us that the GPs offered appointments on the same day when needed and were good at communicating with staff and patients’ families.
• The practice had no travellers or homeless people on their patient list at the time of our inspection, but had previously had a homeless patient and explained they would provide urgent clinical care to these patient groups as required.
• The practice collaborated with other health care professionals in the case management of patients living in circumstances that made them vulnerable.
• The practice informed patients about how to access various support groups and voluntary organisations.
• The practice offered additional services to carers such as a free annual flu vaccination and health check. There was a dedicated carer’s information board in the patient waiting area.
• The practice had systems and processes in place to safeguard patients from abuse, but the practice nurse was overdue for annual refresher training in children’s safeguarding.