Archived: Whyburn Medical Practice

Updated 3 January 2017

Whyburn Medical Practice is in Hucknall, which is seven miles north-west of Nottingham. The practice  is located in a purpose built health centre. 

The practice provides primary medical services to 11,810 patients via a Personal Medical Services (PMS) contract commissioned by NHS England and Nottingham North and East Clinical Commissioning Group (CCG).  Data shows the practice has a higher than national average elderly population.  

Whyburn Medical Practice  is managed by a partnership of seven GPs (4 male, 3 female). Two of the partners work on a full time basis and the other partners work part time. The GPs are supported by three part time practice nurses and a part time healthcare assistant. The practice also employs a business manager, reception manager, data quality manager and a team of reception and administrative staff.

The practice is a training practice for medical students and GP registrars (a qualified doctor who is completing training to become a GP). 

The practice is open Monday to Friday from 8am to 6.30pm. Appointments are available Mondays to Fridays from 8.30am to 6pm. The practice does not provide extended opening hours. 

The practice has opted out of providing out-of-hours services to its patients.  This service is  provided by Nottingham Emergency Medical Services (NEMS) and is accessed via the NHS 111 telephone number. 

Updated 3 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Whyburn Medical Practice on 26 May 2016.  During that inspection we found that effective recruitment procedures were not followed as not all required information was available on three staff files we checked.  

Overall the practice was rated as good with are services safe requiring improvement in view of the above.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Whyburn Medical Practice on our website at www.cqc.org.uk.

After the comprehensive inspection, the practice told us what action they had taken to meet the legal requirement in relation to the breach of Regulation 19-Fit and proper persons employed.

We undertook a desk based review on 25 November 2016 to check that the provider had completed the required action, and now met the legal requirement. We did not visit the practice as part of this inspection. This report covers our findings in relation to the requirement.

This inspection found that the provider had taken appropriate action to meet the legal requirement.

• Effective recruitment procedures were followed to ensure the required information was obtained prior to new staff working at the practice, to provide assurances that suitable staff are employed.
• Personal files had been reviewed to ensure the required information was available in respect of staff employed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 1 September 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, to help keep them safe and well in their own homes.

• National data showed the practice was performingabove the local CCG average for its achievement within 11 diabetes indicators.The practice achieved96% of the available QOF points compared with the CCG average of 87%. Achievement was also above the national average of 89%.

• The practice offered a variety of services for patients with long term conditions which included insulin initiation for those with diabetes and in-house spirometry, a test that can help diagnose various lung conditions such as chronic obstructive pulmonary disease (COPD) and monitor the severity of other lung conditions. Cardiomemo fittings were also offered which monitor patients’ heart activity.

• 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.

Updated 1 September 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 for all standard childhood immunisations ranged from 92% to 99%. This was comparable to CCG averages which ranged from 88% to 98%.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and our discussions with staff supported this.

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

• We saw that effective collaborative working took place between the doctors in the practice, midwives and health visitors.

Updated 1 September 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. All older patients had a named GP. All care homes where patients were residing had a nominated GP who undertook regular visits. A care home manager we spoke with praised the practice for having the same GP undertaking these visits and told us this worked effectively for patients and ensured good continuity of care.

• Care plans had been implemented for those patients identified as at risk of emergency admission into hospital. The practice held regular multidisciplinary meetings where all patients who were vulnerable and requiring intervention were discussed with input from other care teams into their holistic care.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. The practice also offered vaccinations to those housebound patients. The practice had a positive uptake for its flu vaccination programme.

Updated 1 September 2016

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

• The practice offered appointments on weekdays up until 6pm which enabled some flexibility for working age patients, students and those recently retired to attend. Routine appointments were available for booking up to one month in advance. The practice also provided a telephone triage system for patients who required urgent health advice. One of the practice GPs would telephone a patient on the same day they contacted the practice for advice.
• 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.
• The practice operated an annual flu clinic on Saturdays to enable those of working age to attend for their vaccination.

Updated 1 September 2016

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

• 90% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months. This was above the CCG average of 88% and national average of 84%. Exception reporting was in line with the CCG average and national average.

• 90% of patients with a mental health condition had a documented care plan in place in the previous 12 months. This was above the CCG average of 86% and above the national average of 88%. Exception reporting was 11.8% below the CCG average and 5.8% below the national average.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. Patients were encouraged to self refer to an onsite counselling service.

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

Updated 1 September 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 including those with a learning disability. There were 61 patients on the learning disability register and 53 of these had received an annual health check in the last twelve months.

• We were provided with anonymised examples where the practice had worked closely with the community learning disabilities coordinator to ensure care and treatment resulted in improved outcomes for patients.

• The practice was directly involved in fund raising activities to help the vulnerable homeless within the local community.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations. A number of self help organisations contact details were made available for patients which included The Samaritans, Depression Alliance, Anorexia and Bulimia Care (ABC) and Adfam (advice to families and friends of drug users).

• The practice provided a substance misuse service for those patients registered at the practice as well as other neighbouring practices who would benefit.

• 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.