Walford Mill Medical Centre

Updated 1 March 2017

Walford Mill Medical Centre, located at Knobcrook Road, Wimborne, Dorset BH21 1NL is a purpose built practice. There is an independent pharmacy on site and car parking facilities.

The practice patient list was just over 6441 patients. The percentage of patients over 65 years is higher than the Dorset Clinical Commissioning Group average and above the average for England. There is a higher prevalence of chronic disease and life limiting illness for patients, with associated risks of isolation and vulnerability in old age. There is low social deprivation in the area. All of the patients have a named GP.

Walford Mill Medical Centre has three GP Partners, two female and one male. The GP partners are supported by two female GPs and one male salaried GP. The practice has a specialist nurse, a senior nurse, two practice nurses and a healthcare assistant. Administrative and reception staff are managed by a practice manager who works closely with the rest of the team. There is also community nurses and a health visitor that support the practice in delivering care to patients in the community.

The practice is open between 8.30am and 6.30pm Monday to Friday. Appointments are from 8.30am to 12pm every morning and 2pm to 6.30pm daily. Extended hours appointments are offered between 6.30 and 7.30pm every Monday and Wednesday and one Saturday morning per month. Telephone appointments are available Monday to Friday by arrangement. Patients are able to book routine appointments on line up to three months in advance. Information about opening times and appointments is listed on the practice website and patient information leaflet.

When the practice is closed, patients are directed to the out of hours services, provided by the Dorset Emergency Care Service via 111.

The practice has a Personal Medical Service (PMS) contract.

The following regulated activities are carried out at the practice: Treatment of disease, disorder or injury; Surgical procedures; Family planning; Diagnostic and screening procedures; Maternity and midwifery services.

Updated 1 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Walford Mill Medical Centre on 30 November 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• Patients experienced flexible services that aimed to provide choice and continuity of care. The practice had a higher percentage of patients over 75 years compared with the national average and had developed services to meet their needs. Examples included individualised approach to triage by the patients own GP. Tracker nurses (carrying out home visits) working closely with GPs to support vulnerable patients resulting in a reduction of unplanned hospital admissions.
• 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 was piloting an integrated multidisciplinary approach to monitoring vulnerable patients in the community.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. The practice reviewed its staffing requirements in line with changing patient demand. Staff were actively encouraged to develop their skills and had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• All 21 patients who gave feedback 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.
• 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 practice achieved high levels of performance with patient involvement about decisions of their care and treatment. For example, 98% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is better than the national average of 84%.

We saw one area of outstanding practice:

A pilot was underway for a new approach to triage patients under 16. This aimed to increase parent awareness of red flag symptoms requiring urgent assessment, such as a high fever and promotion of self management were appropriate.  Although in the early stages of the pilot, some positive outcomes were seen.  Records demonstrated the practice had identified parents needing additional support, had put this in place and were receiving prompt assessment and reassurance when their child was ill.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 1 March 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.

• 97% of patients on the diabetes register, had a record of a foot examination and risk classification within the preceding 12 months, which is above the national average of 88%.

• 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.

Updated 1 March 2017

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

• The practice was trialling a new approach to triage of patients under 16. This aimed to increase parent awareness of red flag symptoms requiring urgent assessment and promotion of self management were appropriate. Although in the early stages of the pilot, some positive outcomes were seen. Records demonstrated the practice had identified parents needing additional support, had put this in place and were receiving prompt assessment and reassurance when their child was ill.

• 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.

• 87% of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding 5 years ) which is above the 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, health visitors and school nurses.

Updated 1 March 2017

The practice is rated as outstanding 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.

• Patients experienced flexible services that aimed to provide choice and continuity of care.The practice had a higher percentage of patients over 75 years compared with the national average and had developed services to meet their needs.Examples included individualised approach to triage by the patients own GP.Tracker nurses (carrying out home visits) working closely with GPs to support vulnerable patients resulting in a reduction of unplanned hospital admissions.

• There was proactive identification of carers and patients being cared for, with 3% of the total patient list recorded as such.Additional support was available such as prioritisation of appointments to support carers.

• Enhanced appointments lasting up to 20 minutes were available for older and vulnerable patients with chronic health conditions and complex needs.

Updated 1 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.

Updated 1 March 2017

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

• 98% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is better than the national average of 84%.

• 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.

Updated 1 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.

• 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.

• 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.