Archived: Dr David Mackenzie Bush Also known as Penn Surgery

Updated 21 March 2016

Dr David Mackenzie Bush practice (also known as Penn Surgery) is located in one of the less deprived areas of Wolverhampton. The practice provides medical services to approximately 4,954 patients. The practice has a higher proportion of patients between the ages of 40 to 85+ years compared with the practice average across England. There is a lower practice value for income deprivation affecting children and older people in comparison to the practice average across England. The practice has a higher percentage of patients with a long standing health condition and also a higher percentage of nursing home patients than the practice average across England.

The practice staff team consists of a principle GP and three salaried GPs, (two male and two female). The clinical practice team includes a practice nurse and two healthcare assistants. Practice staff also include a practice manager and nine administration/ receptionists support staff. In total there are 16 staff employed either full or part time hours to meet the needs of patients. The practice is a training practice for GP registrars and medical students to gain experience and higher qualifications in general practice and family medicine.

The practice is open Monday to Friday. Opening times are 8.30am to 6pm Monday to Wednesday, Thursday 8.30 to 1pm and Friday from 7am to 6pm. Appointments are from 8.30am to 11.30am and 3.30pm to 5.30pm Monday to Wednesday, 8.30am to 11.30am on Thursdays and from 7am to 8am, 8.30am to 11am and 3.30pm to 5.30pm on Fridays. Extended surgery hours are from 7am to 8am on Friday mornings. The practice does not provide an out-of-hours service to its patients but has alternative arrangements for patients to be seen when the practice is closed. Patients are directed to the out of hours service Primecare, the NHS 111 service and the local Walk-in Centres. This information was available on the practice answerphone, patient leaflet and practice website.

The practice has a contract to provide General Medical Services (GMS) for patients. This is a contract for the practice to deliver primary medical services to the local community. They provide Directed Enhanced Services, such as the childhood vaccination and immunisation scheme and minor surgery. The practice provides a number of clinics for example long-term condition management including asthma, diabetes and high blood pressure.

Updated 21 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr David Mackenzie Bush practice on Thursday 28 January 2016. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses. There was an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered 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 the 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 21 March 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. Performance for diabetes assessment and care was slightly above the national average (93% as compared to the national average of 89.2%). 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 multidisciplinary package of care. Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

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, for example, children and young people who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations. Data showed that 75.22% of patients on the practice register had had an asthma review in the last 12 months. 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 and health visitors. The practice’s uptake for the cervical screening programme was 80.56%, which was comparable to the national average of 81.83%.

Updated 21 March 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 offered home visits and urgent appointments for those older patients with enhanced needs. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice had a proactive working relationship with nursing care homes. There was effective communication between the practice and care home staff and visits to the homes were made when requested.

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

Updated 21 March 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The data showed that 91.67% of patients on the practice register who experienced poor mental health had a comprehensive agreed care plan in the preceding 12 months. This was comparable to the national average of 88.47%. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. The practice regularly worked with multi-disciplinary teams in the case management of people who experienced poor mental health, including those with dementia. It carried out advance care planning for patients with dementia. The percentage of patients diagnosed with dementia whose care had been reviewed in a face to face review in the preceding 12 months was 85%, which was comparable to the national average of 84.01%. Staff had a good understanding of how to support people with mental health needs and dementia.

Updated 21 March 2016

The practice is rated good for the care of people whose circumstances may make them vulnerable. The practice held a register of patients with a learning disability and carried out annual health checks for these patients with the support of the community learning disability nursing team.

The practice provided a service to patients who suffered domestic abuse. Staff were aware of their responsibilities regarding confidentiality, information sharing, documentation of safeguarding concerns and how to contact relevant agencies. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told vulnerable patients about how to access various support groups and voluntary organisations. Staff had been trained to recognise signs of abuse in vulnerable adults and children.