Edgwick Medical Centre

Updated 31 January 2017

Edgwick Medical Centre is located in the Foleshill district of Coventry. The practice is a group practice and had 4478 patients registered at the time of our inspection. Foleshill is an urban area and the practice has a significant number of patients from ethnic minority groups – 80%, with Asian and eastern European being the most common. As a result, most patients do not speak English as a first language. There is also considerable deprivation as Foleshill is the 13th most deprived local authority ward in England. A large number of patients have long term medical conditions, for example, 10% of patients registered at the practice have diabetes – double the national average.

The practice has a General Medical Services (GMS) contract with NHS England. The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities. The practice is part of a local GP federation known as the GP Alliance. A federation is formed of a group of practices who work together to share best practice and maximize opportunities to improve patient outcomes.

Edgwick Medical Centre has two partner GPs (one male and one female), along with one locum GP (male) who is usually based at the practice. There are also two practice nurses and at the time of our inspection the practice was part way through the recruitment process to employ a healthcare assistant. They are supported by a practice manager and administrative and reception staff.

The practice is open from 8am to 6.30pm during the week. Appointments are available throughout those times. Extended hours appointments are available on Mondays from 6.30pm to 7.45pm.

When the practice is closed, patients can access out of hours care provided by Coventry and Warwickshire NHS Partnership Trust located in the City of Coventry Healthcare Centre through NHS 111. The practice has a recorded message on its telephone system to advise patients. This information is also available on the practice’s website.

Home visits are available for patients who are unable to attend the practice for appointments. There is also an online service which allows patients to order repeat prescriptions and book new appointments without having to telephone the practice. Telephone appointments are available for patients who are unable to reach the practice during normal working hours.

The practice treats patients of all ages and provides a range of medical services. This includes minor surgery and disease management such as asthma, diabetes and heart disease. The practice also cares for 35 patients at a nearby nursing home, all of whom have dementia.

Edgwick Medical Centre is an approved training practice for doctors who wish to be become GPs. A GP trainee is a qualified doctor who is training to become a GP through a period of working and training in a practice. Only approved training practices can employ GP trainees and the practice must have at least one approved GP trainer. However, at the time of our inspection, the practice was not operating as a training practice due to constraints on GP’s time.

Updated 31 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Edgwick Medical Centre on 22 November 2016. Overall the practice is rated as good.

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

• There were clearly defined processes and procedures to ensure patients were safe and an effective system was for reporting and recording significant events.
• Patients said they were treated with dignity, respect and compassion. Patients were involved with decisions about their care and treatment.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care delivered in line with current guidelines. Staff had the appropriate skills, knowledge and experience to deliver effective care and treatment.
• Urgent same day patient appointments were available when needed. The majority of patients we spoke with and those who completed comment cards before our inspection said they were always able to obtain same day appointments, although a small number said it could be difficult to get an appointment at times.
• Information about how to complain was available and easy to understand.
• Patients said GPs gave them enough time and treated them with dignity and respect.

The area where the provider should make improvements are:

• Continue work already in progress to identify more patients who were carers.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 31 January 2017

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

• The practice had a register of patients with long term conditions to enable their health to be effectively monitored and managed.

• Longer appointments and home visits were available when needed.

• Patients had a named GP and a review every 12 months to monitor their condition and ensure they received correct medicines. This also included carers if the patient had one. The frequency of the review depended on the severity of the patient’s condition. Due to the high prevalence of diabetes in the local area, patients with this condition were reviewed every nine months.

• All patients who had been prescribed eight or more medicines had a medicines’ review within the last 12 months.

• The practice achieved a 98% influenza vaccination record for diabetic patients during 2015/16. This was above the CCG average of 93% and the national average of 94%.

Updated 31 January 2017

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

• A total of 86% of eligible patients had received cervical screening in the last 12 months. This was above the CCG average of 81% and the national average of 81%.

• There were appointments outside of school hours and the practice building was suitable for children and babies.

• Outcomes for areas such as child vaccinations were in line with the average for the CCG.

• We saw positive examples of joint working with midwives and the local health visitor. Midwife appointments were available at the practice every week.

• A monthly multi-disciplinary team meeting was held with the midwife and health visitor. The child protection register and non-attendance for immunisations and checks were reviewed at this meeting.

A full range of family planning and sexual health services were available within the practice building.

Updated 31 January 2017

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

• Care plans were in place with the most vulnerable older patients (2%) and used with multi-disciplinary teams to reduce unplanned hospital admissions. These patients had an alert placed on their patient records to ensure clinical staff were aware.

• Older patients were given personalised care which reflected their needs.

• Over the last 12 months all patients aged 75 and over had been invited for a health check. This included blood tests, fracture assessment, frailty assessment, and checks for depression and dementia. From those checks, the practice identified patients who needed further investigation and referred them appropriately. Over the last 12 months, 53% of patients over the age of 75 had responded to the invitation for a health check.

• Home visits were offered to patients who could not reach the practice.

Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people.

Updated 31 January 2017

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

• The practice ensured it provided services to meet the needs of the working age population, For example, extended hours appointments were available on Mondays from 6.30pm to 7.45pm.

• Telephone consultations were available for patients who were unable to reach the practice during the day.

• Regular reviews of the appointment system were held to ensure patients could access the service when they needed to. This had recently resulted in additional telephone appointments being made available.

A full range of services appropriate to this age group was offered, including travel vaccinations and smoking cessation.

Updated 31 January 2017

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

• The practice had a register of patients with poor mental health to enable their health to be effectively monitored and managed.

• The practice worked with multi-disciplinary teams to provide appropriate care for patients with poor mental health. This included patients with dementia.

• Patients were signposted to appropriate local and national support groups.

• Staff demonstrated a good working knowledge of how to support patients with mental health needs and dementia.

Updated 31 January 2017

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

• The practice had a register of patients who were vulnerable to enable their health to be effectively monitored and managed. This included patients with a learning disability.

• The practice participated in the learning disability enhanced service and offered comprehensive reviews by clinical staff who had undertaken relevant training.

• The practice supported vulnerable patients to access various support groups and voluntary organisations.

• Longer appointments were available for patients with a learning disability.

• The practice worked with other health care professionals to provide care to vulnerable patients, for example, the district nursing team and community matron. Vulnerable and complex patients were discussed at the monthly multi-disciplinary team meeting.

Staff could recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities to share appropriate information, record safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.