Westfield Road Surgery

Updated 12 April 2017

Dr Robinson and Partners, also known as Westfield Surgery, is based at 11 Westfield Road Bletchley, Milton Keynes, MK2 2DJ and provides services from a single storey, purpose built location. There is a small car park with designated disabled parking bays and additional parking is available nearby. The practice serves a population of approximately 5,926 patients with a lower than average male and female population aged between 65 and 85 years. National data indicates the area served is of average deprivation in comparison to England as a whole and has low levels of unemployment.

The reception area is equipped with electronic patient arrival registration screens and a hearing loop for the hard of hearing.

The clinical team consists of two GP partners (one male and one female), a nurse practitioner, two practice nurses and a phlebotomist. The team is supported by a practice manager, a practice advisor and a team of reception and administration staff. The practice uses three regular locum GPs (one male and two female) to support the partners.

The practice holds a General Medical Services (GMS) contract for providing services, which is a nationally agreed contract between general practices and NHS England for delivering general medical services to local communities. The practice undertakes a number of regulated activities; diagnostic and screening procedures, family planning, maternity and midwifery services and treatment of disease, disorder or injury.

The practice is open between 8am and 6.30pm Mondays to Fridays. With extended hours appointments available on Monday and Wednesday mornings from 7.30 and 7am respectively. When the practice is closed the out of hours service is provided by Milton Keynes Urgent care Services (MKUCS) for patients requiring the services of a GP. Information about this is available in the practice and on the practice leaflet, website and telephone line.

Updated 12 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Robinson and Partners, also known as Westfield Road Surgery, on 13 December 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 and recording significant events.
• Risks to patients were assessed and well managed.
• The practice had a comprehensive business continuity plan.
• Emergency medicines and equipment were stored securely but easily accessible.

• Staff were aware of their responsibilities in helping to safeguard and protect patients and had undertaken specific training appropriate to their role to support this.
• Data from the national GP patient survey published in July 2016 showed patients rated the practice higher than others for several aspects of care.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment. They worked well with multidisciplinary teams, including community and social services to plan and implement care for their patients.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice had identified 84 patients as carers (approximately 1.6% of the practice list).
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• The practice held regular staff and clinical meetings where learning was shared from significant events and complaints.
• Patients had commented that it was sometimes difficult to contact the practice by telephone and this was being addressed by the practice by offering online access and planning to upgrade the current system.
• The practice offered extended hours appointments.
• 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.

The areas where the provider should make improvement are:

• Improve patient access to the practice by telephone and monitor patients satisfaction levels with this.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 12 April 2017

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 multidisciplinary package of care.
• The percentage of patients with diabetes, on the register, in whom the last IFCCHbA1c was 64 mmol/mol or less in the preceding 12 months was 70%, where the CCG average was 77% and national average was 78%.

• One of the GPs in the practice had a special interest in diabetes and had introduced care planning for diabetic patients along with referring them to specific education programmes to improve outcomes for this group of patients.
• The percentage of patients with chronic obstructive pulmonary disease (COPD) who had a review undertaken including an assessment of breathlessness in the preceding 12 months was 93% which was comparable to the CCG average of 91% and national average of 90%.

Updated 12 April 2017

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.
• 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.
• The practice’s uptake for the cervical screening programme was 74% which was comparable to the CCG average of 82% and the national average of 81%.
• The female GP and a practice nurse offered a monthly contraceptive fitting service.
• 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. All community staff were invited to practice safeguarding meetings.

Updated 12 April 2017

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.
• Immunisation for flu and pneumococcal vaccinations were available at the practice or were offered at home or in local nursing homes if required.
• Patients over the age of 75 had a named GP and were included in the Avoiding Unplanned Admissions (AUA) register and had personalised care plans in place.
• The practice carried out weekly ward rounds in a local care home.

Updated 12 April 2017

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 offered extended hours appointments on a Monday and Wednesday mornings from 7.30am and 7am respectively, for patients who could not attend during normal opening hours.
• The practice enrolled in the electronic prescribing service (EPS) which allowed easy access to repeat prescriptions and patients were able to collect medicine from a pharmacy of the patients’ choice.
• Flu vaccinations were available at the practice. Patients were able to book appointments on Saturday for vaccinations if needed.
• The practice enrolled in the electronic prescribing service (EPS) which allowed easy access to repeat prescriptions and patients were able to collect medicine from a pharmacy of the patients’ choice.
• 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. 

Updated 12 April 2017

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 below the local CCG and national averages. For example: The percentage of patients with diagnosed psychoses who had a comprehensive agreed care plan was 68% where the Milton Keynes Clinical Commissioning Group (CCG) average was 90% and the national average was 89%. The practice recognised the low figures and had introduced a specific weekly clinic for patients with poor mental health to attend to undertake reviews and support this patient group.  Following the inspection the practice submitted evidence of improvement in some areas however this was unverified data.
•  percentage of patients diagnosed with dementia whose care has been reviewed in a face-to-face review in the preceding 12 months was 75% where the CCG average was 86% and the national average was 84%. Additional clinics were being held to complete all reviews by the end of March 2017.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice carried out advance 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 A&E, 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.

Updated 12 April 2017

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 homeless people, travellers and those with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients. For example, the practice supported the local High Impact Team when required, via tele-consultation or home visits. This team worked with local care homes to reduce the need for residents to go into hospital as ‘unplanned’ emergency admissions by proactively managing their health and care needs and focussing on prevention.
• 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.