Background to this inspection
Updated
11 June 2018
Westongrove Partnership – Wendover Health Centre in Buckinghamshire provides primary medical services to the population of Wendover, Bedgrove, Aston Clinton and surrounding smaller villages. The practice is a semi-rural training practice within Buckinghamshire Clinical Commissioning Group (CCG) and provides primary medical services to approximately 28,600 registered patients.
Services are provided from three different locations:
- The Health Centre, Aylesbury Road, Wendover, Buckinghamshire HP22 6LD
- Bedgrove Surgery, Brentwood Way, Bedgrove, Buckinghamshire HP21 7TL
- Aston Clinton Surgery, 136 London Road, Aston Clinton, Buckinghamshire HP22 5LB
The practice website is:
During the April 2018 inspection we visited the main practice in Wendover and also one of the branch practices, Bedgrove Surgery.
According to data from the Office for National Statistics, Buckinghamshire, specifically the Wendover, Bedgrove and Aston Clinton areas have high levels of affluence, low levels of deprivation and little ethnic diversity. The practice population has a significantly higher proportion of patients aged over 60 when compared to the local CCG and national averages. The practice also provides primary care GP services for 11 local care and nursing homes (approximately 400 patients) within the local area.
Care and treatment is delivered by nine GP Partners, 14 Salaried GPs, a paramedic, a pharmacist, three nurse team leaders and a team of practice nurses and health care assistants. One of the GPs is the designated dispensary lead and the dispensary team consists of three dispensers and two dispensary assistants.
A Senior Management Team consisting of a GP Partner, Operations and Development Manager and Human Resources and Finance Manager oversee three site managers. The management team are supported by a team of reception, administrative and secretarial staff who undertake the day to day management and running of Westongrove Partnership.
The practice is a training practice for GP Registrars and Medical Students. GP Registrars are qualified doctors who undertake additional training to gain experience and higher qualifications in general practice and family medicine.
One of the practices (Wendover Health Centre) was able to offer dispensing services to those patients on the practice list who lived more than one mile (1.6km) from their nearest pharmacy.
The practice has core opening hours between 8.30am and 6.30pm every weekday. There is a range of extended hours available.
- Wendover Health Centre – Early morning appointments are available with appointments starting at 7.30am, Monday to Friday. Evening appointments are available every Tuesday evening until 8pm and weekend appointments are available on Saturday mornings between 8.15am and 11.30am.
- Bedgrove Surgery – Early morning appointments are available with appointments starting at 8am, Monday to Friday. Evening appointments are available every Wednesday evening until 8.30pm.
- Aston Clinton Surgery – Early morning appointments are available with appointments starting at 8am, Monday to Thursday and 7.30am each Friday. Evening appointments are available every Wednesday evening until 8pm.
The dispensary has core opening hours between 8.30am and 6.30pm every weekday. Extended dispensary hours were available on Tuesdays between 8am and 8pm and Saturday mornings between 9am and 11am.
Out of hours care is accessed by contacting NHS 111.
The practice is registered by the Care Quality Commission to carry out the following regulated activities: Maternity and midwifery services, Family planning services, Treatment of disease, disorder or injury, Surgical procedures and Diagnostic and screening procedures.
Updated
11 June 2018
This practice is rated as Good overall.
The previous inspection was in December 2014 and the practice was rated Good.
The key questions at this inspection are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Outstanding
We carried out an announced comprehensive inspection at Westongrove Partnership – Wendover Health Centre in Buckinghamshire on 23 April 2018. We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions.
This inspection was planned to check whether the practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.
At this inspection we found:
- The practice had comprehensive systems in place to manage and monitor risks to patients, staff and visitors. This included risks to the building, environment, medicines management, staffing, equipment and a range of emergencies that might affect operation.
- Patient outcomes and information collected for the Quality Outcome Framework (QOF), the local performance scheme (known as Primary Care Development Scheme) and performance compared to national screening programmes was high.
- The practice routinely reviewed the quality and effectiveness of the care it provided. Care and treatment was delivered according to evidence based guidelines. We saw that a wide range of clinical audits were carried out and there was a whole practice approach to improvement.
- The leadership, governance and culture were used to drive and improve the delivery of its service. All staff were involved in the development of the practice and were proud of their achievements.
- The practice reviewed the needs of their local population and had initiated positive services for patients.
- Services were tailored to meet the needs of individual people and were delivered in a way that ensured flexibility and choice.
- There was a strong focus on education, continuous learning and improvements at all levels in the practice. When incidents did happen, the practice learned from them and improved their processes.
- There was evidence that service improvement was a priority among staff and leaders. High standards were promoted by all practice staff and there was strong team working and a commitment to personal and professional development.
We saw several areas of outstanding practice:
- The practice leadership was committed to meeting the needs of its population. This was evidenced through themed and targeted services, clinical audits and health promotion. This included a range of initiatives to meet the needs of specific groups – for example older people and people with dementia.
- The practice was aware of an increasing elderly population within the community. This led to the development of a service specifically for older people; this service was known as The Weston Service. The focus was to support patients (aged over 75) and their carers with a GP led nurse team to oversee and co-ordinate health and social needs. We saw the practice reviewed and audited the efficiency of the service; we saw recent data which indicated the service had 70 new cases and reduced hospital admissions by 33% (101 avoided admissions). The service and the impact on patients have been recognised both locally and nationally. For example, the project won an innovation award from the Queen’s Nursing Institute (a nationally recognised award celebrating innovation and commitment to patient care and nursing practice) and Bucks County Council Dignity and Respect awards.
- There was clear, inclusive and effective leadership at all levels. Leaders demonstrated the high levels of experience, capacity and capability needed to deliver sustainable care. There were deeply embedded systems of leadership which aimed to ensure that senior staff had considered the needs for the future.
There was an area where the provider should make improvements:
- Consider the implementation of a hearing loop system at all three sites to support patients with impaired hearing.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice