Wilson Street Surgery

Updated 24 November 2023

Wilson Street Surgery is a teaching practice and is located in Derby at:

11 Wilson Street

Derby

DE1 1PG

The practice has a branch surgery at:

Taddington Road Surgery

Taddington Road

Chaddesden

Derby

DE21 4JU

We visited both of these practices as part of our inspection.

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services, treatment of disease, disorder or injury and surgical procedures. These are delivered from both sites.

The practice offers services from both a main practice and a branch surgery. Patients can access services at either surgery.

The practice is situated within the Joined Up Care Derbyshire Integrated Care System and delivers General Medical Services (GMS) to a patient population of about 15,838. This is part of a contract held with NHS England.

The practice is part of the Derby City North Primary Care Network (PCN), a wider network of 5 GP practices that work collaboratively to deliver primary care services.

Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the second lowest decile (2 of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 75.7% White, 15.6% Asian, 3.7% Black, 3.3% Mixed, and 1.8% Other.

The age distribution of the practice population demonstrates a lower proportion of older patients and a higher number of working age patients compared to local and national averages:

• The percentage of older people registered with the practice is 12.7% which is below the local average of 20.5% and the national average of 17.8%.
• The percentage of working age patients registered with the practice is 69.7% which is above the local average of 60.2% and the national average of 62.4%.

There is a team of 7 GP partners and a salaried GP who provide cover at both practices. The practice has a team of 4 practice nurses and 2 advanced clinical practitioners. Clinical staff are supported at the practice by a team of 20 reception and administration staff. The practice manager and 2 assistant practice managers provide managerial oversight. Through the PCN, the practice also has access to the services of clinical pharmacists, pharmacy technicians, first contact physiotherapists, social prescribers, health and wellbeing coaches and mental health occupational therapists. The PCN also funds a care coordinator, physician associate and paramedic to work in the practice.

The main practice is open between 8am to 6.30pm Monday to Friday. The branch practice is open between 8am to 12pm Monday to Friday. The practice offers a range of appointment types including face to face and telephone consultations which can be pre-booked or booked on the day. Patients can book appointments over the telephone or online.

Extended access is provided locally by Derby City North Primary Care Network, where late evening and weekend appointments are available. Out of hours services are provided by Derbyshire Health United (DHU).

Updated 24 November 2023

We carried out an announced comprehensive inspection at Wilson Street Surgery on 6 and 9 October 2023. Overall, the practice is rated as good. We rated the practice as good for providing safe, effective and caring services, requires improvement for providing responsive services and outstanding for providing well-led services. The CQC recognises the pressure that practices are currently working under and the efforts staff are making to maintain levels of access for their patients. At the same time, our strategy makes a commitment to deliver regulation driven by patients’ needs and experiences of care. Although we saw the practice was attempting to improve access, this was not yet reflected in the GP National Patient Survey data or other sources of patient feedback.

At our previous inspection on 9 March 2016, the practice was rated outstanding overall and for the key questions effective and responsive. They were rated good for the key questions safe, caring and well-led. We rated the practice as outstanding for providing effective and responsive services because:

• Quality and outcome indicators showed patient outcomes were at or above average compared with national averages. The practice demonstrated a strong track record of effective prescribing including ensuring low rates of antibiotic prescribing.
• The practice demonstrated a strong commitment to improving access to healthcare for people who were vulnerable.

At this inspection, we found that the practice had continued to demonstrate a strong and innovative commitment to improve access to healthcare for people who were vulnerable. However, due to poor patient satisfaction, as demonstrated in the GP National Patient Survey, regarding access to appointments the threshold to achieve an outstanding rating for providing responsive services had not been reached. The practice is therefore now rated good for providing effective services and requires improvement for providing responsive services.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Wilson Street Surgery on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection in line with our inspection priorities.

• We inspected the key questions safe, effective, caring, responsive and well-led.
• We followed up on the best practice recommendation that the practice should continue to review telephone access for patients to improve the ease of patients contacting the practice by telephone.

How we carried out the inspection.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Conducting staff interviews using video conferencing.
• Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A site visit.
• Speaking with a representative of a care home where the provider provided care and treatment.

Our findings

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We rated the provider as Good for providing safe, effective and caring services because:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice provided additional in-house services to reduce the workload on secondary care services and could demonstrate the positive impact of these services.
• The provider pioneered initiatives that focused on identifying and improving care for moderately frail patients.

We rated the practice as Requires Improvement for providing responsive services because:

• Patient satisfaction with telephone access to appointments was below the national average.

We rated the practice as outstanding for providing well-led services because:

• There was dynamic, compassionate, inclusive and innovative leadership in place which drove improvements in the delivery of high quality person-centred care. This included collaborative partnerships, multidisciplinary and multiagency working which tackled health inequalities. The provider could clearly demonstrate the positive impact this had on health outcomes for under-represented populations such as homeless people, asylum seekers, frail patients and those struggling with the cost of living crisis.
• Leaders embraced innovations and proactively sought out and embedded new ways of working to provide care and treatment to its diverse population. Equality, diversion and inclusion underpinned all of this work.
• Staff feedback was highly positive about the support provided to staff and staff were proud to work at the practice.

Whilst we found no breaches of regulations, the provider should:

• Update the infection control and prevention audits and action plans to include the need to replace the carpet, sink and taps in consultation rooms where these had not been updated.

• Continue to embed into practice strategies to increase the uptake rate of childhood immunisations and cervical screening.
• Continue to review and drive improvements to increase patient satisfaction with telephone access to appointments.
• Include details of the Integrated Care Board (ICB) and Parliamentary and Health Service Ombudsman (PHSO) in the complaint response letters to patients so they are informed of who to contact if they are unsatisfied with the results of the complaint investigation.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care