Warrengate Medical Centre

Updated 17 May 2016

The Warrengate Medical Centre is located in on the periphery of Wakefield town centre and provides services for around 8,800 patients. The practice surgery is located in purpose built premises dating from 2001. The surgery has parking to the front and side. The surgery is easily accessible for those with mobility issues and entry into the building is made via automatic doors. There is ample space within the building lobby and waiting room for prams, pushchairs and mobility scooters. The practice is a member of the NHS Wakefield Clinical Commissioning Group (CCG.)

The practice population age profile shows that it is slightly under the England average for those over 65 years old (16% compared to the England average of 18%), whilst the age profile for under 18s is slightly above the England average (21% compared to the England average of 20%). Average life expectancy for the practice population is 76 years for males and 80 years for females (England average is 79 years and 83 years respectively). The practice is located in an area of higher than average deprivation being ranked in the second most deprived decile. The practice population is predominantly White British although around 38% of the practice is composed of patients with an Asian or Eastern European background.

The practice provides services under the terms of the Personal Medical Services (PMS) contract. In addition to this the practice offers a range of enhanced local services including those in relation to:

• Childhood vaccination and immunisation

• Influenza and Pneumococcal immunisation

• Rotavirus and Shingles immunisation

• Dementia support

• Improving online access

• Risk profiling and care management

• Support to reduce unplanned admissions.

• Minor surgery

• Learning disability support

• Extended hours opening

As well as these enhanced services the practice also offers additional services such as those supporting long term conditions management including asthma, chronic obstructive pulmonary disease, diabetes, heart disease and hypertension and smoking cessation.

Attached to the practice or closely working with the practice is a varied team of community health professionals including health visitors, midwives, and members of the district nursing team.

The practice has five GP partners (two male, three female) and one salaried GP (female), there is also a GP Registrar (male) working at the practice. In addition there are three practice nurses , a healthcare assistant and a phlebotomist, who are all female. Clinical staff are supported by a practice manager and an administration and reception team.

The practice holds training practice status and offers training to registrars and medical students.

The practice offers a range of appointments, these include:

• A triage system for incoming telephone appointment calls – patients have their needsassessed by a triage nurse. Treatment options are then offered to the patient including same or next day appointments, home visits, self-treatment advice or signposting to other services.

• Telephone appointments/consultations – bookable on the day if available or in advance.

• Pre-bookable face to face appointments.

The practice is open Monday to Friday 8am to 6.30pm, with appointment times being 8.30am to noon and 2pm to 6pm. In addition the practice also offers late evening appointments on Mondays and Tuesdays after 6.30pm; these appointments are for patients who find it difficult to attend during normal surgery opening times.

Appointments can be made in person, via telephone or online.

The practice also participates in a local extended hours/out of hours service, Trinity Care, which operates across the local network. Patients can call the service on weekdays 6.30pm to 8pm and on weekends and bank holidays 9am to 3pm. Calls are triaged and an appointment made with a doctor should this be necessary. This network response was originally funded by the CCG following a business case from the network and is now being funded by the Wakefield multispecialty community provider Vanguard programme.

Outside of the Trinity Care service, out of hours care is provided by Local Care Direct Limited and is accessed via the practice telephone number or patients can contact NHS 111.

Updated 17 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Warrengate Medical Centre on 1 March 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, recording and taking remedial action in relation to 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 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.
• Patients said they found it easy to make an appointment with a named GP and that 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 17 May 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.

• The practice provided a shared care diabetes clinic for patients which was led by a diabetic consultant and a practice nurse.

• Longer appointments and home visits were available for those patients who needed them.

• Patients had structured six monthly or annual reviews to check their health and medicines needs were being met. For those patients with the most complex needs, the practice worked with health and care professionals to deliver a multidisciplinary package of care.

• The practice held regular DESMOND training sessions for patients (Diabetes Education and Self Management for Ongoing and Newly Diagnosed - a course for people with type 2 diabetes that helps people to identify their own health risks and to set their own goals).

Updated 17 May 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

• National and local Immunisation targets were consistently achieved for all standard childhood immunisations.

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

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

• The health visitor attended the monthly practice meeting and was able to discuss safeguarding issues directly with clinical staff.

• The patient participation group had a representative for young people.

Updated 17 May 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; this included a named GP for those over 75 years old.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. In addition the practice delivered an avoiding unplanned admissions service which provided proactive care management for patients who had complex needs and who were at risk of an unplanned hospital admission.

• The practice held an annual abdominal aortic aneurysm clinic for patients in conjunction with Leeds Teaching Hospitals NHS Trust.

• The practice had participated in the West Riding Nursing and Residential Home pilot scheme and had continued to be part of the now mainstreamed service as part of the Wakefield Vanguard Connecting Care programme. As part of the programme the practice provided clinical sessions at a nearby nursing home during which patient health needs were met and care plans were reviewed. Since introduction there was an 87% increase in the number of care plans developed for residents.

• The practice hosted a monthly patient led arthritis drop-in session, where patients could obtain advice and information on the condition.

• The practice encouraged and supported older people to participate in national screening programmes including those in relation to bowel and breast cancer. This had resulted in significant increases in uptake.

Updated 17 May 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. For example, the practice offered telephone appointments and extended hours on a Monday and Tuesday evenings. In addition the practice

• The practice was proactive in encouraging and supporting patients to attend thenational screening programmes for cervical, breast and bowel cancer. This had resulted in significant increases in uptake since 2013 - 22% for cervical screening, 48% for breast screening and 83% for bowel screening.

• The practice had a social media account, where people could access health advice.

• 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, this included online booking of appointments and repeat prescriptions.

Updated 17 May 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 better than the national average. For example, 92% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record in the preceding 12 months compared to a national average of 88%.

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

• The practice was dementia friendly, staff had received dementia awareness training and the signage in the practice and the clock in the reception area was designed to be easier to understand and comprehend.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• All dementia patients were placed on the avoiding unplanned admissions scheme and received advanced care planning.

Updated 17 May 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 and used this to plan reviews.

• The practice offered longer appointments for patients with a learning disability.

• The practice was registered under the Wakefield Safer Places Scheme. This was a voluntary scheme which assisted vulnerable people to feel safer and more confident when travelling independently away from the home environment.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations, this included local carers groups and dementia support groups.

• 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.

• Staff had received training in British Sign Language.