Werrington Village Surgery

Updated 12 November 2015

Werrington Village Surgery is a General Practice providing services to approximately 7,800 patients from its premises in Werrington, Stoke on Trent.

Data published by Public Health England, shows that 25% of patients are aged 65 and over, this is higher than the clinical commissioning group (CCG) average of 21% and national average of 16%. The practice has over two times the national average number of patients that live in nursing homes. Both of these factors can increase the demands on a GP practice.

The Stoke on Trent area has a rich history of industry, including pottery, manufacturing and coal mining. There are less people living in deprivation in the Werrington area of Stoke on Trent than neighbouring settlements in the city.

The practice holds a General Medical Services contract with NHS England and has committed to providing a number of enhanced services for patients. Enhanced services provide additional services that are not seen as an essential part of a GP practice, for example additional access, care or treatment options on site. The practice also provides daily services to a local young offenders institution (YOI). This is done under a different arrangement and we did not look at the care provided in the YOI as part of this inspection.

Clinical and nursing staffing at the practice consists of five GPs (three female, two male), an advanced nurse practitioner, three practice nurses, a community practice nurse and two healthcare assistants (all female). The wider practice team is managed by a practice manager and assistant practice manager and consists of a further 11 administrative staff and two domestic cleaners.

The practice has opted out of providing out-of-hours cover to patients. These services are provided by Staffordshire Doctors Urgent Care and are accessed by dialling 111.

Updated 12 November 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Werrington Village Surgery on 20 July 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well-led services. It was also good for providing services for older people, people with long-term conditions, families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable and people experiencing poor mental health (including those with dementia).

Our key findings were as follows:

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• The practice had changed the way it handled telephone calls to improve the experience of patients.

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group (PPG).

We saw two features of outstanding practice including:

• The practice had an open and transparent culture were staff were encouraged to raise and discuss concerns that may affect patient safety. The practice had recorded 25 significant events for discussion. Significant events were reviewed with the whole practice team to maximise the learning from them. Often the person who reported the significant event had presented it to the group. When individual error was identified, staff openly reflected on how they had changed the way they worked to minimise the risk of the incident reoccurring.

• The patient participation group (PPG) had changed their constitution to allow all patients to attend meetings and encouraged them to share their thoughts and experiences of the practice. As a result the PPG meetings regularly attracted over 34 attendees. The PPG championed health promotion and improvement and helped patients to understand wider health services and how to access them.

However, there were also areas of practice where the provider should make improvements.

In addition the provider should:

• Review the need for GP held emergency medicines when visiting patients away from the practice building.
• Record clinical patient safety incidents on the National Reporting and Learning System to allow learning that is gained from incidents to be used by others.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 12 November 2015

The practice is rated as good for the care of people with long-term conditions. The nursing team had a lead role 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 that their health and medication 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.

Nationally reported data from 2013/14 showed that outcomes for patients with long-term conditions were in line with others. For example, 82.5% of patients with diabetes had received a recent blood test that indicated their longer term blood glucose control was below the highest accepted level compared to the clinical commissioning group (CCG) average of 82.3% and national average of 87.1%.

Updated 12 November 2015

The practice is rated as good for the care of families, children and young people. There was a formal system in place to identify and follow up children living in disadvantaged circumstances and who were at risk. Immunisation rates were in line with the local average 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. Appointments were available outside of school hours and the premises were suitable for children and babies

Updated 12 November 2015

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 and had a range of enhanced services. For example, in dementia and avoiding unplanned hospital admissions. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. All patients over the age of 75 had a named GP.

Updated 12 November 2015

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 as well as a full range of health promotion and screening that reflected the needs of this age group.

Updated 12 November 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Ninety per cent of patients on the practice register for dementia had received an annual physical health check. 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 practice had told patients experiencing poor mental health about 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) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

Updated 12 November 2015

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 with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients. It had told 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.