Willowbrook Medical Centre

Updated 7 April 2016

Willowbrook Medical Centre provides primary medical services to approximately 9754 patients in Leicester City. The practice also provides services to patients residing in 12 residential care and nursing homes in the surrounding area.

Willowbrook Medical Centre is located in a suburban area on the north eastern outskirts of the City of Leicester and covers the areas of Humberstone, Clarendon Park, Knighton, Thurnby Lodge, Evington, Bushy and Thurnby. It is located within the area covered by Leicester City Clinical Commissioning Group (CCG). It is registered with the Care Quality Commission to provide the regulated activities of; the treatment of disease, disorder and injury; diagnostic and screening procedures; family planning; maternity and midwifery services and surgical procedures.

The practice patient population scores slightly higher than the England average in terms of income deprivation affecting older people and children but is lower than the average for all the other practices within its CCG area.

At the time of our inspection the practice employed four GP partners, four salaried GPs, two GP Registrars, a nurse practitioner, three practice nurses and a phlebotomist. They are supported by a practice manager, administration and reception staff. The surgery is open from 7.30am to 6pm Monday to Friday. Appointments are available from 7.30am each day.

The practice has a General Medical Services (GMS) contract. The GMS contract is the contract between general practices and NHS England for delivering care services to local communities.

The surgery is purpose built, spacious, and is of single storey construction, providing good access to patients and carers. Level car parking is available and some bays close to the entrance doors are designated for the use of patients with restricted mobility.

The practice has two locations registered separately with the Care Quality Commission (CQC) which is Willowbrook Medical Centre, 195 Thurncourt Road, Leicester, LE5 2NL and a branch surgery located at Springfield Road Health Centre, Springfield Road, Leicester, LE2 3BB.

The practice operates an advanced access appointment system which enables patients to book a routine appointment up to four weeks in advance. The practice also offers telephone consultations for routine enquiries, advice and medication queries. In addition to pre-bookable appointments that can be booked in advance, urgent appointments are also available for people that need them. All patients who require an urgent on the day appointment can receive a telephone consultation with a GP first. The practice offers on-line services for patients such as on-line appointment booking and ordering repeat prescriptions.

The practice is a member of a federation of ten GP practices within Leicester City which look after approximately 100,000 patients. A federation is a group of GP practices that work collaboratively with a shared mission and vision to share best practice and provide a greater range of services for patients. The federation has been successful in the provision of a clinical pharmacist working within the ten GP practices. The federation has also been successful in establishing an under-graduate training academy for medical student training in conjunction with Leicester University. It is hoped that this project will encourage more students to enter into employment within general practice in Leicester City.

The practice has an active patient participation group (PPG) who meet every two months.

The practice is a training practice and delivers training to GP Registrars. A GP Registrar is a fully qualified Doctor who is training to become a GP.

Updated 7 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Willowbrook Medical Centre – JG Astles on 18 November 2015. 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 and recording significant events.
• Risks to patients were assessed and well managed.
• There was a GP lead which specialised in screening for the detection of chronic diseases such as atrial fibrillation, asthma and heart disease which had led to earlier diagnosis and a reduction in accident and emergency attendances and unplanned hospital admissions.
• All staff had received Mental Capacity Act Training.
• Childhood immunisation rates for the vaccinations given were higher than CCG/national averages.The practice attended regular meetings with health visitors.
• The practice had an active patient participation group (PPG) who met every two months.
• 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.
• A clinical pharmacist worked in the practice on a weekly basis to carry out medication reviews with patients, undertook medicines and prescribing audits and took a lead role for medicines management.
• 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. GP partners had lead roles in various clinical areas. 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.
• The practice had an infection control lead and a policy in place however, clinical waste was not always stored appropriately.

The areas where the provider should make improvement are:

• Review the system for the safe storage of clinical waste.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 April 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.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multi-disciplinary package of care.

• The practice participated in an admissions avoidance scheme and delivered personalised care plans and regular reviews for patients with a long term condition with a view to deliver more personalised care and to reduce emergency or unplanned hospital admissions.

• The practice employed a paramedic who delivered care planning and home visits for patients with long term conditions.

• There was a GP lead for the screening and detection of chronic diseases which resulted in earlier detection and active treatment for those patients diagnosed with a long term health condition.

• All GP partners were end of life leads within their locality.

Updated 7 April 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, for example, children and young people who had a high number of A&E attendances.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• Childhood immunisation rates for the vaccinations given were higher than CCG/national averages. For example, childhood immunisation rates for the vaccinations given to under two year olds ranged from 95% to 97.2% and five year olds from 93.5% to 99.4%.

• The practice provided childhood immunisation clinics.

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

• We saw positive examples of joint working with midwives, health visitors and school nurses.The practice held regular meetings with health visitors.

• There was a named midwife who provided two clinics per week in the practice.

Updated 7 April 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.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• Patients received personalised care plans from a named GP to support continuity of care.

• The premises were accessible to patients with mobility difficulties.

• Those at high risk of hospital admission and end of life care needs were identified and reviewed regularly, this included working with other health professionals to provide co-ordinated care.

• Age UK provided a monthly drop-in session in the practice for patients.

• The practice participated in a care navigation scheme which provided a wide range of support to older people through home visits from a care navigator to help them remain healthy and to help patients carry on living in their own homes.

• The practice participated in the ‘Better Care Fund Plans’ scheme and delivered effective care planning for older people to ensure better and more integrated care, to improve out of hospital care and reduce emergency hospital admissions.

Updated 7 April 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 to ensure these were accessible, flexible and offered continuity of care.For example, extended hours appointments were available and online services such as ordering repeat prescriptions and appointment booking for the convenience of patients who worked or had other commitments during the day.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.

• A range of health promotion and screening was available including NHS health checks, smoking cessation and travel advice and vaccinations.

• The practice’s uptake for the cervical screening programme was 81.26%, which was higher than the CCG average of 73.3%.

• There was a GP lead for the NHS health check programme.

• An automated arrival machine was available to give patients the opportunity to arrive themselves for their appointment rather than speak to a receptionist.

Updated 7 April 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 in the case management of people experiencing poor mental health, including those with dementia.

• The practice carried out advanced care planning for patients with dementia.

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

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

• All staff had received Mental Capacity Act training.

• The Alzheimer’s Society provided an in-house protected time awareness session for all staff about Dementia.

• The practice referred patients with mental health needs to a mental health nurse. The mental health nurse also attended regular multi-disciplinary meetings in the practice to review patient needs.

Updated 7 April 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 for example those with a learning disability. The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people and ensured care plans and regular reviews were in place.

• The practice held a regular ‘unique care’ meeting which involved GPs, practice nurses, district nurses and a locality social services co-coordinator.The meeting was held to discuss patients identified as at risk of unplanned admission to hospital. Decisions were agreed regarding their continuation of care.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• 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.

• There were alerts on patient care records to alert clinicians of specific needs of vulnerable families and children.

• All staff received Mental Capacity Act training and were aware of how to ensure patients were involved in decisions about their care.

• All staff have had received safeguarding adults and children training.

• All patients identified as vulnerable had a care plan in place which was reviewed regularly.