Archived: Victoria Medical Practice

Updated 20 April 2017

Victoria Medical Practice is located on Wellington Road, Dewsbury, West Yorkshire, WF13 1HN on the first floor of Dewsbury Health Centre. The building is a large multi-purpose health centre with a pharmacy and is owned by community provider, Locala. The practice is located centrally in Dewsbury opposite the train station and close to shops and the market.

The practice provides primary care to 2,915 patients under an alternative personal medical services (APMS) contract. This is a contract between general practices and NHS England for delivering services to the local community. The National general practice profile shows that 37% of the practice population is from a south Asian background with a further 3% of patients from mixed and other non-white ethnic groups.

There are fewer patients registered with the practice aged over 44 than the clinical commissioning group (CCG) or national average.

There is one salaried male GP, one female advanced nurse practitioner, a female practice nurse who is undergoing training to become an advanced nurse practitioner and an additional practice nurse who provides cover for the nurse and the healthcare assistant as required.

The practice is open between 8am and 6.30pm Monday to Friday. Appointments are available throughout the day between these times. Extended hours appointments are offered until 7.30pm

on a Monday.

When the practice is closed services are provided by Local Care Direct and NHS 111.

Updated 20 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Victoria Medical Practice on 21 September 2016. Overall the practice is rated as good. The practice is rated as requires improvement for safety.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.

• Risks to patients were mostly assessed and well managed, with the exception of those relating to the vaccine refrigerator and cold chain.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients 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 areas where the provider must make improvement are:

• The practice must ensure staff understand and follow practice policies and procedures for the management of the vaccine refrigerator and the preservation of the cold chain.

The areas where the provider should make improvement are:

• The practice should review the arrangements for regularly reviewing the immunisation status of care workers and providing vaccinations to staff as necessary in line with current guidance.
• The practice should review their arrangements for clinical audit at the practice. Clinical audit should be clearly linked to patient outcomes, monitored for effectiveness and comprise of two or more cycles to monitor improvements to patient outcomes.
• The practice should take steps to improve their identification of patients who are carers, in order to be able to provide them with any additional support they may require.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 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.
• Performance for diabetes related indicators was better than the national average. Data showed that 95% of patients with diabetes, on the register, had a record of a foot examination and risk classification in the preceding 12 months (CCG average 89%, national average 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.
• The practice were involved in the shared care of patients taking disease-modifying anti-rheumatic drugs (DMARDs). These are medicines that are normally prescribed as soon as rheumatoid arthritis is diagnosed, in order to reduce damage to the joints.
• The practice offered spirometry testing (a test that measured lung health) in-house and data showed an improvement of 14% of patients having their diagnosis confirmed since 2013/14.

Updated 24 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 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.
• The practice’s uptake for the cervical screening programme was 84%, which was better than the CCG and national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• Patients in need of contraception were signposted to the contraceptive and sexual health clinic which was based in the same building.

Updated 24 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.
• The practice encouraged its patients to attend national screening programmes for bowel and breast cancer screening. Data showed that uptake was low. For example, 28% of patients aged 60 to 69 were screened for bowel cancer in the preceding 30 months (CCG average 55%, national average 58%). The practice used alerts on patient records for clinicians to remind patients about the importance of screening.
• The practice used the Electronic Palliative Care Coordination Systems (EPaCCS) shared care records to document care for patients approaching the end of life, including their expressed preferences for care.
• Patients at risk of hospital admission, but not under the care of the community matron, were referred to the CCG care co-ordinators. The practice worked with and referred patients to a care co-ordinator who helped patients to manage their health and liaised with NHS and social care services to ensure patients were supported.
• Home visits were available for older patients and patients who had clinical needs which resulted in difficulty attending the practice. The advanced nurse practitioner attended a nursing home on a weekly basis where a number of patients resided.

Updated 24 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.
• The practice offered extended hours clinics on a Monday evening until 7.30pm for working patients who could not attend during normal opening hours.
• Patients could register and book appointments online.

Updated 24 November 2016

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 had their care reviewed in a face to face meeting in the preceding 12 months, which was better than the national average of 84%.
• 98% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive care plan documented in the record, in the preceding 12 months (CCG average 89%, national average 88%).
• 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 24 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.
• Clinical staff carried out alcohol intervention advice. They used AUDIT-C which is a recognised screening tool that can help identify persons who are hazardous drinkers or have active alcohol use disorders.