Archived: North Wingfield Medical Centre

Updated 19 April 2017

The practice is situated in North Wingfield a large village in the county of Derbyshire. The building is a single ground level with good access for disabled patients. The practice supports a population with high unemployment in an area of high deprivation and has a list of approximately 3750 patients.

The practice has two female GPs and two male salaried GPs, a practice nurse prescriber and two health care assistants who work closely with reception and administrative staff on one site. The practice operates on a primary medical services (PMS) contract.

The practice is open between 8:00am and 6:30pm Monday to Friday. Appointments are from 8:00am to 12:30 every morning and 2:30pm to 6:30pm daily. Extended hours surgeries are offered at 7:30 every Wednesday and Friday for pre bookable appointments only. Out of hours (OOH) cover is provided by Derbyshire Health United from 6:30pm to 8:00am through the 111 system.

We inspected this practice under the previous inspection regime on 20 November 2013 and due to concerns raised about the safeguarding procedures and assessments of risk during the inspection a further inspection was conducted on 19 June 2014, where it was found the practice had put in place effective systems to manage these areas.

We carried out our inspection at the practice’s only location which is situated at:

Chesterfield Road

North Wingfield

Chesterfield

S42 5ND

Updated 19 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced focused inspection of North Wingfield Medical Centre on 2 February 2017. This inspection was undertaken to follow up on areas we identified for improvement following the initial inspection. Specifically the system in place for sharing learning and outcomes of significant events with staff, completion of an action plan following a risk assessment for legionella and telephone access to the practice.

The practice received an overall rating of good at our inspection on 29 October 2015 and this will remain unchanged until we undertake a further full comprehensive inspection in the future. You can read the report from the last comprehensive inspection, on our website at www.cqc.org.uk.

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

• The practice had reviewed the way in which significant events were managed. An effective system was in place which enabled staff to track the progress of investigations and outcomes. This ensured information was available to all staff at any stage which allowed for their contribution. This encouraged open discussion and learning.
• Following the inspection all areas highlighted in the legionella risk assessment had been actioned and changes had been made such as monitoring the water temperature on a monthly basis.
• Oxygen had been purchased following the initial inspection and had been used on several occasions. It was now a standard item of emergency equipment.
• An assessment of the way calls were handled at peak times had been undertaken and a new processes had been put in place to improve the availability of staff to answer incoming calls.

Chief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 February 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. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 18 February 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 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. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 18 February 2016

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 18 February 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 early appointments, including blood tests and GP appointments before work as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 18 February 2016

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

The practice is involved in a dementia roll out project which aims to provide a practice based Dementia Support Worker and Community Psychiatric Nurse to facilitate the early diagnosis of dementia as well as post diagnosis support in primary care, reducing the need for referrals to secondary care. It had a system in place to follow up patients who had attended accident and emergency department (A&E) where they have been experiencing poor mental health and care plans put in place to reduce further attendances.

Staff adopt a multi-disciplinary team approach to the care of the most vulnerable patients and have close links to psychological therapy services, alcohol teams and domestic violence support workers, all of whom can access a room in the practice to see patients on request.

Updated 18 February 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. Patients who were identified as vulnerable had an alert on their records so staff were aware of their needs and could allocate extra time onto the appointment.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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, they 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.