Witton Medical Centre

Updated 8 November 2016

Witton Medical Centre is located on Preston Old Road in Witton, west of Blackburn town centre, Lancashire. The medical centre is located in a conversion of two terraced houses in a residential area. There is easy access to the building and disabled facilities are provided. There is some car parking on the main road and reserved parking in a private car park opposite to the surgery.

The practice holds a General Medical Services (GMS) contract with NHS England and forms part of Blackburn and Darwen Clinical Commissioning Group.

There are five GPs working at the practice, two of whom are partners. One of the partners is male and one female. There are also three salaried GPs, two male and one female. A long standing locum GP works four sessions each week. There is a total of 4.25 whole time equivalent GPs available plus the locum sessions. There are five female nurses, two of whom are full time nurse practitioners. The three practice nurses are part time. There is a full time practice manager, an office manager, a medicines management coordinator and a team of administrative staff.

The practice opening times are 8am until 7.30pm Monday and 8am until 6.30pm Tuesday to Friday. Appointments are available 8.30 to 11.30am and 2.30 to 7.30pm on Monday and 2.30 to 6.30pm Tuesday to Friday.

Patients requiring a GP outside of normal working hours are advised to call East Lancashire Medical Service, an out of hours service, or call the 111 service who will either call an ambulance or suggest  they attend Accident and Emergency. There are 10,240 patients on the practice list. The majority of patients are white British with a high number of elderly patients and patients with chronic disease prevalence. On the Index of Multiple Deprivation the practice is in the third most deprived decile with a score of eight. This practice offers placements to medical students from the University of Manchester.

Updated 8 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Witton Medical Centre on 2 August 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.
• 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.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about the services provided 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.
• Patients said they found it easy to make an appointment with a named GP and 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 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.

We saw one area of outstanding practice:

• The practice was given a silver award for quality for teaching practise for medical students during 2014/15 by the University of Manchester

The areas where the provider should make improvements are :

• Carry out a regular audit for infection prevention and control
• Facilitate full analysis and review of significant events in order to identify trends
• Raise the awareness for patients to the availability of chaperones
• Introduce easy to read information for people with learning disabilities.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 8 November 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 related indicators was better than the national average.

• 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 practice worked closely with the Medicines Management Team from the clinical commissioning group and provided data through audits to improve the quality ofprescribing.

Updated 8 November 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 and those who did not attend secondary care appointments. There were 85 Children on the child protection register and details were highlighted on records, with alerts for staff and clinicians. These children were regularly discussed at the monthly Primary Healthcare Team Meetings.

• Immunisation rates were relatively high for all standard childhood immunisation programmes achieving up to 95% in 2014/15 the same as the clinical commissioning group (CCG). These were provided both at immunisation clinics and by appointment.

• 80% of women aged 25-64 were recorded as having had a cervical screening test in the preceding 5 years. This compared to a CCG average of 80% and a national average of 82%.

• 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.

• All parents or guardians calling with concerns about a child under the age of 10 were offered a same day appointment.

• Young people were signposted or referred to appropriate services such as Child and Adolescent Mental Health and Counselling services e.g. Brook Advisory and Eating Disorder services.

Updated 8 November 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 was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• Practice staff visited one care home in the area to provide ward rounds, confer with staff and managers and provide advice on medicines management. Patients were also registered at a number of other care homes and the nurse practitioner worked closely with the Community Matron in the locality and ensured good continuity of care.

• There were 194 patients on the Avoiding Unplanned Admissions register all of whom had a care plan.

• The practice worked with the Complex Nursing team and Community Respiratory Team to manage acute exacerbations of long term illnesses for the older population.

• Integrated Primary Care team meetings were held on a monthly basis, where patients were selected and reviewed along with palliative care patients.

• The practice referred to a national charitable organisation for assessment of patients’ social needs.

Updated 8 November 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. This included pre-bookable appointments and a late surgery on a Monday evening.

• The practice was proactive in offering online services including repeat prescriptions as well as a full range of health promotion and screening that reflects the needs for this age group.

• Health checks had been extended to patients aged between 35-74years.

• Telephone triage and telephone consultations were offered daily.

• A smoking cessation service was offered after 5pm on a Monday evening.

Updated 8 November 2016

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

• 91% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record in the preceding 12 months. This compared with a clinical commissioning group average of 92% and a national average of 88%.

• 93% of patients with mental health conditions had their alcohol consumption recorded in the preceding 12 months. This compared well with the national average of 89%.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations such as Minds Matters and the Wish Centre.

• The practice offered direct access to counselling and other mental health services via the Improving Access to Psychological Therapies ( IAPT) scheme.

Updated 8 November 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 homeless people, travellers and those with a learning disability.Alerts for direct access to GPs or nursing staff were added to records of these patients.

• The practice offered longer appointments for patients with a learning disability.

• We saw no evidence of easy read material suitable for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients including hospice staff, palliative care nurses and district nurses. This included multidisciplinary integrated care meetings to ensure patients received safe, effective and responsive care.

• 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.

• Practice staff identified patients who were carers. A carers’ information board was maintained in the waiting room. All carers were offered the influenza vaccination.

• The local community drug and alcohol team held twice weekly clinics at the surgery.

• The practice spoke with local pharmacies with regards to arranging blister packs for vulnerable patients.

• Referrals to a national charity and social services were made for relevant patients.