Archived: Leicester Road

Updated 21 March 2016

Leicester Road Surgery is located in Bedworth, north Warwickshire and provides primary medical services to patients in an urban and semi-rural area. Locally there are some areas of deprivation. There is also a higher than average rate of long-term medical conditions amongst older people due to Bedworth being a former coal mining community.

The practice is managed by Malling Health and 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. It is located in a converted house and has 2,440 patients registered. This includes patients in three local care homes.

The practice is staffed by a lead salaried GP (male) who is also the lead GP for the other three Malling Health GP practices located in the Warwickshire North Clinical Commissioning Group (CCG). There are two locum GPs (male and female) who are permanently based at the practice, a practice nurse (who is a nurse prescriber and therefore able to issue prescriptions) and a healthcare assistant. They are supported by a practice manager and administrative and reception staff. Staff at the practice supported and were supported by staff in the other local GP practices within the group.

At the time of our inspection, the practice had re-advertised for an additional salaried GP after an earlier recruitment exercise had been unsuccessful. The practice manager was an interim practice manager from the group, brought in after the previous post-holder had left the practice.

Leicester Road Surgery is open from 8am to 6.30pm during the week, with appointments available throughout those times. The practice had not been able to provide an extended hours service for 2015-2016, but had plans to do so during 2016-2017. When the practice is closed patients can access out of hours care 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 and in the patient practice leaflet.

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.

The practice treats patients of all ages and provides a range of medical services. This includes disease management such as asthma, diabetes and heart disease. Other appointments are available for services such as family planning and smoking cessation. 

Updated 21 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Leicester Road Surgery on 8 December 2015. Overall the practice is rated as good for providing safe, effective, caring, responsive and well led services. Leicester Road Surgery is part of Malling Health (referred to as ‘the group’ in this report).

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

• It was clear during our inspection that the current management team had made improvements since taking over this practice and were continuing to do so at the time of our inspection. A detailed practice improvement plan was in place which set clearly identifiable goals and timescales for achieving them.
• The practice had good facilities and was well equipped to treat patients and meet their needs. At the time of our inspection audit of equipment was being carried out to ensure the right equipment was in the right place throughout the local practices within the group.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.

• Risks to patients were assessed and well managed. Appropriate systems were in place to ensure safety was a top priority.

• Staff had the skills, knowledge and experience to deliver effective care and treatment. Staff resources were shared with other practices in the group to enable practices to support each other and share best practice. The practice was looking at ways to develop this further and had started a staff skills analysis to facilitate this.

• There was a clear leadership structure and staff felt supported by management. The practice was supported by the group’s regional management team.

• The practice proactively sought feedback from staff and patients, which it acted on.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 21 March 2016

The practice is rated as good for the care of people with long-term conditions. The practice had systems in place to monitor patients with chronic diseases. Patients at risk of hospital admission were closely monitored. Longer appointments and home visits were available when needed. Patients were reviewed at least annually, sometimes more frequently depending on the condition they had and its severity. All patients diagnosed with a long term condition had a named GP and a structured annual review to check that their health and medicine needs were being met. Patients were encouraged to discuss anything relating to their condition at any time with a member of the clinical staff, rather than wait until their next review. For those patients with the most complex needs, the GP and practice nurse worked with relevant health and care professionals to deliver a multidisciplinary package of care. The practice also offered dietary, weight management and smoking cessation advice.

Updated 21 March 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 of abuse. For example, children and young people who had a high number of accident and emergency (A&E) attendances.

The practice worked with the locally based community midwife and health visitor teams. Patients who were pregnant were given telephone numbers and details of locations where they could be contacted locally as they were no longer based within the practice. Post-natal checks were carried out by the GPs. The practice had a policy of providing same day appointments for children and appointments were also available outside of school hours. The premises were suitable and accessible for children, with changing facilities for babies. The practice notified Child Health Services when babies and children did not attend for their vaccinations.

The practice also offered a number of online services including booking appointments and requesting repeat medicines.

Updated 21 March 2016

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population. It was responsive to the needs of older people, and offered home visits for those unable to reach the practice. GPs also made proactive visits to three care homes where patients lived. Health checks were carried out for all patients over the age of 75 years. At the time of our inspection, the practice had implemented its 2015-2016 flu vaccination programme. The practice worked with other providers, such as community matrons to reduce unplanned hospital admissions. Carers of patients had a dedicated telephone line to use to contact the practice.

Updated 21 March 2016

The practice is rated as good for the care of working-age people (including those recently retired and students). The needs of this population group had been identified. Telephone consultations were available for patients who were unable to reach the practice during the day. The practice had identified a need for extended hours opening and planned to apply for this provision for 2016-2017. The practice offered online services as well as a full range of health promotion and screening services that reflected the needs for this age group. The practice nurse had oversight for the management of a number of clinical areas, including immunisations.

Updated 21 March 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice regularly worked with multi-disciplinary teams, for example, the community mental health team, to plan care and treatment with patients who experienced poor mental health, including those with dementia. It carried out advanced care planning and annual health checks for patients. The GPs and practice nurse understood the importance of considering patients’ ability to consent to care and treatment and dealt with this in accordance with the requirements of the Mental Capacity Act 2005.

The practice had advised patients experiencing poor mental health how to access various support groups and voluntary organisations. It had a system in place to follow up patients who had attended accident and emergency (A&E). Staff had received training on how to care for people with mental health needs and dementia.

Updated 21 March 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 patients with a learning disability. The practice carried out annual health checks and offered longer appointments for patients when needed, for example, for patients with a learning disability.

The practice regularly worked with multi-disciplinary teams, for example the community mental health team and district nursing team in the case management of vulnerable people. It had advised vulnerable patients on how to access various support groups and voluntary organisations. Alerts were placed on these patients’ records so that staff were aware they might need to be prioritised for appointments. The practice identified and closely monitored vulnerable patients who frequently attended accident and emergency (A&E). Carers of patients had a dedicated telephone line to use to contact the practice.

Staff had received training and knew how to recognise signs of abuse in adults whose circumstances made them vulnerable and children who were considered to be at risk of harm. 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.