Lucie Wedgwood Surgery Limited

Updated 12 June 2017

Lucie Wedgwood Health Centre is registered with the Care Quality Commission as a partnership provider. The practice currently holds a Personal Medical Services (PMS) contract with NHS England. A PMS contract is a locally agreed alternative to the standard General Medical Services (GMS) contract used when services are agreed locally with a practice which may include additional services beyond the standard contract.

The practice is situated within a health centre that also houses other NHS services; the location is close to the centre of Burslem. There is no car park attached to the practice, although limited time free parking is available at a local authority car park nearby.

At the time of our inspection the practice had 5,902 registered patients. The age range of patients registered at the practice broadly follows local and national averages. The demographic of the practice differs from others in some respects:

• The level of deprivation in the local area is significantly higher than local and national averages.

• Unemployment and the number of patients living with a long standing health condition are higher than local and national averages.

• The average life expectancy of people living in the local area is four years less for both males and females than national averages.

The practice staffing comprises of:

• Two male GP partners.

• One salaried male GP.

• One female locum GP.

• Two female practice nurses (one combines this role with that of a practice manager).

• One health care assistant.

• A team of secretaries, administrators and receptionists working a range of hours.

The practice is open: Monday 7:00am to 6pm, Tuesday 7.30am to 8pm, Wednesday 7.30am to 6pm, Thursday 7.30am to 5pm and Friday 7.00am to 6pm. The practice has opted out of providing cover to patients in the out-of-hours period. During this time services are provided by Staffordshire Doctors Urgent Care, patients access this service by calling NHS 111.

Appointments can be made online, by telephone or face-to-face. The practice also offers video consultation appointments for patients over the age of ten, that do not require an immediate physical examination.

In preparation for the inspection we identified that the practice had changed their partnership, although applications to vary the CQC registration to reflect the changes had not been received. The provider has been prompted to submit the relevant applications at the earliest opportunity.

Updated 12 June 2017

Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection at Lucie Wedgwood Health Centre on 27 September 2016. The overall rating for the practice was Good with requires improvement in providing safe services. The full comprehensive report from the 27 September 2016 inspection can be found by selecting the ‘all reports’ link for Lucie Wedgwood Health centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 24 May 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 27 September 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as Good.

Our key findings were as follows:

• There was an effective system to ensure that patients who took medicines had a review by an appropriate clinician and consideration was given to the monitoring for side effects.

• There was a system for obtaining satisfactory information about any physical or mental health condition that staff members may have which are relevant to the role they undertook.

• The practice had recorded the action taken in response to all medicines and equipment alerts issued by external agencies.

• The practice had reviewed the oxygen therapy equipment in use to ensure it could be easily deployed within the practice as required.

• The practice had reviewed the method of storing and moving emergency medicines within the practice. The provider had obtained appropriate emergency medicine to treat possible complications associated with the insertion of specific intrauterine contraceptive devices.

We also saw the following best practice recommendations we previously made in relation to providing effective and responsive services had been actioned:

• Discussions and actions taken about changes in clinical practice, for example national guidance, were now recorded during clinical meetings held.

• Patients were advised of the escalation process should they not be happy with the outcome of their written complaint.

However, there was still one area of practice where the provider could make improvements.

The provider should:

• Ensure the complaints procedure is readily accessible to patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 29 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.

• Four per cent of patients at the highest risk of unplanned admission had a personalised care plan in place. If admitted to hospital, patients were followed up soon after discharge to ensure care met their needs.

• 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 29 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. Immunisation rates were higher than national levels 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.

• 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.

Updated 29 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.

Updated 29 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.

• 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.

• Earlier and later appointments were offered on a weekly basis.

Updated 29 November 2016

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

• The practice had 25 patients identified with Dementia. Performance data showed that 80% patients with dementia had a face to face review of their condition in the last 12 months. This was lower than the clinical commissioning group (CCG) average of 85% and national average of 84%.

• The practice had 89 patients identified with an enduring poor mental health condition. Performance for poor mental health indicators showed that 87% of patients with enduring poor mental health had a recent comprehensive care plan in place compared with the CCG and national averages of 90%.

• 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 29 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.

• 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.