Archived: Kidderminster Medical Centre

Updated 20 September 2017

Kidderminster Medical Centre provides services for patients living in Kidderminster. The practice is registered with the Care Quality Commission (CQC) as a partnership provider and holds a General Medical Services (GMS) contract with NHS England. The GMS contract is a contract agreed nationally between general practices and NHS England for primary care services to local communities. At the time of the inspection the practice served a population of 13,842 patients.

Two practices merged in April 2016 to become Kidderminster Medical Centre. The new practice moved into new premises in August 2016 and also joined the Wyre Forest Health Partnership (WFHP) as one of six member sites in December 2015. Functions such as human resources and finance are undertaken by staff at the WFHP. Policies are set at organisational level, but tailored to individual sites. Many of the governance functions are undertaken by the WFHP. For example, significant event analysis is routinely shared by all six sites.

There are 11 GP partners. They are supported by the site manager, an advanced nurse practitioner, eight nurses, two health care assistants, two pharmacists and reception and administrative teams.

Opening hours are from 8am to 6.30pm on Monday to Friday each week with appointments between these times. The practice is closed at weekends. Extended hours appointments are available for pre-bookable appointments from Monday to Friday evenings from 6.30 to 7pm.

The practice does not provide an out-of-hours service but has alternative arrangements for patients to be seen when the practice is closed. For example, if patients call the practice when it is closed, an answerphone message gives the telephone number they should ring depending on the circumstances. Information on the out-of-hours service (provided by the NHS 111 service) is available in the patient practice leaflet and on the website.

Home visits are available for patients who are housebound or too ill to attend the practice for appointments. The practice operates a dedicated GP led home visiting service for patients, assessing and responding to all visit requests including urgent requests from other practices within the WFPH.

There is also an online service which allows patients to order repeat prescriptions and book appointments with GPs.

The practice treats patients of all ages and provides a range of medical services. This includes disease management such as lung diseases, asthma and diabetes. Other appointments are available for health checks, childhood vaccinations and contraception advice.

Kidderminster Medical Centre is an approved training practice for trainee GPs, provides medical student training and is involved in the national apprentice scheme.

Updated 20 September 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Kidderminster Medical Centre on 27 July and 10 August 2017. The overall rating for this practice is good.

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

• The practice was aware of and provided services according to the needs of their patient population. Staff received regular training and skill updates to ensure they had the appropriate skills, knowledge and experience to deliver effective care and treatment.
• Risks to patients were assessed and well managed.
• There were processes and procedures to keep patients safe. These included a system for reporting and recording significant events, keeping these under review and sharing learning where this occurred.
• The practice was aware of the requirements of the duty of candour and systems ensured compliance with this.
• Regular meetings and discussions were held with staff and multi-disciplinary teams to ensure that patients received the best care and treatment in a coordinated way.
• Patients told us they were treated with dignity and respect and that they were fully involved in decisions about their care and treatment.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• A carers register was maintained to ensure appropriate support was provided. The practice had identified 3% of their patient population as carers.
• There was a clear leadership structure which encouraged a culture of openness and accountability. Staff told us they felt supported by management.
• The practice monitored and identified areas for improvement through their quality performance data.
• Information about services and how to complain was available and patients told us that they knew how to complain if they needed to.
• There was a strong focus on continuous learning and improvement at all levels.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 20 September 2017

The practice is rated as good for the care of patients 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.
• Nursing staff had received appropriate training in chronic disease management, such as asthma and diabetes.
• Longer appointments and home visits were available when needed.
• 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. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.
• Performance for diabetes related indicators was higher than the local and national averages. For example, patients with a record of a foot examination and risk classification was 97% compared with the CCG and the national averages of 91% and 89% respectively. The practice exception rate of 5% was in line with the CCG average of 5% and lower than the national average of 8%.
• Clinical staff had close working relationships with external health professionals to ensure patients received up to date care.

Updated 20 September 2017

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

• The practice was proactive in offering online services as well as a full range of health promotion and screening services that reflected the needs of this age group.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• Staff had been trained to recognise signs of abuse in vulnerable adults and children and the action they should take if they had concerns. There was a lead GP for safeguarding adults and children. GPs were trained to an appropriate level in safeguarding adults and children.
• There were systems to identify and follow up children living in disadvantaged circumstances and who were considered to be at risk of harm. For example, children and young people who had a high number of accident and emergency (A&E) attendances.
• The practice worked with midwives, school nurse teams and health visitors to coordinate care.
• The practice nurses had oversight for the management of a number of clinical areas, including immunisations, cervical cytology and some long term conditions.
• Childhood immunisation rates for the vaccinations given were comparable to local and national averages.
• The practice offered a number of online services including requesting repeat medicines and booking appointments.
• Baby changing facilities and breast feeding rooms were available to those who needed it.
• Mother and baby checks were carried out as part of the postnatal mother and eight week baby checking processes.

Updated 20 September 2017

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

• The practice offered personalised care to meet the needs of the older patients in its population. It was responsive to the needs of older patients and offered home visits and urgent appointments for those with enhanced needs.
• A range of enhanced services was offered by the practice, such as dementia and unplanned admissions to hospital.
• Monthly multi-disciplinary meetings were held and included discussions on patients receiving end of life care.
• Support was provided for isolated or house bound patients. This included signposting to support services or volunteer services including local community groups or charities such as Age UK.
• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.

Updated 20 September 2017

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

• The practice was proactive in offering a full range of health promotion and screening services that reflected the needs of this age group.
• The practice offered online appointment booking and the facility to request repeat prescriptions online.
• Extended hours appointments were available for pre-bookable appointments on Monday and Friday evenings from 6.30pm until 7pm.

Updated 20 September 2017

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

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• Advanced care planning and annual health checks were carried out for patients with dementia and poor mental health.
• Carers were offered health checks and monitored for their wellbeing. They were signposted to support services such as Alzheimer’s Society or Dementia UK.
• There was a system to follow up patients who had attended accident and emergency (A&E) departments where they may have been experiencing poor mental health.
• Clinical staff had a good understanding of how to support patients with mental health needs. They were trained to recognise patients presenting with mental health conditions and carried out comprehensive assessments.

Data showed the practice performed mainly above local and national levels:

• Patients with mental health concerns such as schizophrenia, bipolar affective disorder and other psychoses with agreed care plans were 96% which was above the CCG average of 92% and above the national average of 89%. The practice exception rate was 7% which was lower than the CCG average of 17% and the national average of 12%.
• Patients diagnosed with dementia whose care had been reviewed in a face-to-face review in the preceding 12 months was 98% which was above the local and national averages of 85% and 84% respectively. The practice exception rate was 2% which was lower than the CCG average of 6% and the national average of 7%.

Updated 20 September 2017

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

• Services were provided for all vulnerable patient groups presenting to the practice. For example, the practice provided services for homeless people, for temporary residents and for patients who lived in a nearby refuge.
• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.
• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.
• Clinical staff regularly worked with multidisciplinary teams in the case management of vulnerable patients. Alerts were added to patients records for staff awareness so that longer appointments could be allocated.
• The practice held a register of patients living in vulnerable circumstances including those patients with a learning disability. Longer appointments were available for patients with a learning disability. The practice had carried out annual health checks for 71% of the 96 patients on their register for 2017.
• Staff interviewed knew how to recognise signs of abuse in patients whose circumstances may make them vulnerable. They 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.