Willingham Medical Practice

Updated 17 March 2017

Willingham Medical Practice is a rural practice based at 52 Long Lane, Willingham, Cambridgeshire CB24 5LB. The branch surgery is based at Magdalene Close, Longstanton, Cambridge CB24 3EG. Both premises have car parking facilities. There is an on-site pharmacy sited at Willingham and a dispensary at Longstanton.

The practice has four partners (three male and one female), plus two regular locum GPs, four nurses and one nursing assistant. The practice employs a practice manager, assistant practice manager, administrative staff, receptionists, a clinical summariser and a practice secretary.

Willingham Medical Centre provides GP services to approximately 8,000 patients under a General Medical Services contract with NHS England.

The practice is open from 8.30am to 6pm Monday to Friday (excluding Thursday afternoons). Extended hours are available on Thursdays from 7.00am and Wednesdays until 7pm. The practice is closed on Thursday afternoons. The branch surgery is open from 8.30am to 11.00am Monday to Friday and the dispensary is open at 8.30am.

The practice offers a variety of clinics and services including immunisations, minor surgery, smoking cessation, phlebotomy and family planning.

The practice has a slightly larger number of females aged 35-49 and children up to age 14 than the national average, and fewer males and females between the ages 15 to 29 years.

The nearest hospitals are Addenbrookes, Papworth and Hinchinbrook and there is a park and ride bus service available to Cambridge, Huntingdon, St. Ives and Addenbrookes

Updated 17 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Willingham Medical Practice on 12 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.
• 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 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.
• 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.
• The practice community team, including community nurses and health visitors, were based either at the Willingham site or the Longstanton branch surgery. The community midwives met with the GPs at the ante natal clinics at both surgeries.
• 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.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Updated 17 March 2017

The practice is rated as good for the care of people with long-term conditions.

• A member of the nursing team was the lead in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Specialist nurse led clinics were available for patients with diabetes.

• The practice used the information collected for the Quality and Outcome Framework (QOF) to monitor outcomes for patients (QOF is a system intended to improve the quality of general practice and reward good practices). Data from 2015/2016 showed that performance for diabetes related indicators was 98%, which was 8% above the CCG and national average. Exception reporting for diabetes related indicators was 10%, which was below the CCG average of 13% and the national average of 11%, (exception reporting is the removal of patients from QOF calculations where, for example, the patients are unable to attend a review meeting or certain medicines cannot be prescribed because of the side effects).

• Longer appointments and home visits were available when needed.

• 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.

• Whole person annual reviews were offered which included medicines, general health and concerns and anxieties.

Updated 17 March 2017

The practice is rated as good for the care of families, children and young people.

• Midwife led antenatal clinics were available at both the Willingham and Longstanton sites.

• 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.Staff were aware of Gillick competence (this is a term used to decide whether a child under the age of 16 is able to consent to his or her own medical care).

• The practice’s uptake for the cervical screening programme was 87%, which was above the CCG and national average of 82%.

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

• Same day appointments were offered to children.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

• Contraceptive advice was offered during consultations including implants and pill checks. The practice offered a chlamydia screening service.

• Appointments could be booked online with a total of nine online appointments per GP per day.

Updated 17 March 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.

• The practice utilised the Joint Emergency Team (JET) service for assessment and multi-disciplinary team input to support patients and avoid unnecessary hospital admissions.

• Multidisciplinary team meetings took place to discuss patients with complex needs and those requiring palliative care.

Updated 17 March 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 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.

• Telephone consultations were available and text reminders for appointments.

• The practice offered referrals to weight management schemes

• NHS health checks were offered to patients aged between 40 – 75 years old.

Updated 17 March 2017

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

• 94% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was 7% above the CCG average and 10% above the national average. Exception reporting for patients receiving the intervention was 6%, which was 2% below the CCG average and 1% below the national average.

• 99% of patients with severe mental health issues had a comprehensive agreed care plan documented in the last 12 months, which was 5% above the CCG average and 6% above the national average. Exception reporting for patients receiving the intervention was 12%, which was comparable to the CCG average of 13% and the national average of 11%.

• 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 accident and emergency 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 and had received training in these areas.

• The practice had an open door policy for patients with mental health issues where access was available the same day.

• Counselling services were available for patients for all patients including those with mental health issues.

Updated 17 March 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. Coding of specific patient groups were undertaken at registration and the practice computer system highlighted when patients were in need of additional help i.e. longer appointment times or same day access.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• 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.