Archived: Whitehall Medical Practice

Updated 25 August 2016

Whitehall Medical Practice is registered with the Care Quality Commission as an organisation provider. The organisation, Malling Health joined with IMH Group during 2015. They are a clinically led group which provide services at 50 locations, including GP practices, walk-in, and urgent care centres as a network of primary care sites based across the UK. IMH’s aim is to enable GPs to spend more time with their patients by taking care of the running of practice functions such as training, practice operations, CQC support and facilities management and to help the NHS deliver its five year forward plan. Their central teams are based in Manchester and they provide field based operational support and head office support to staff.

Whitehall Medical Practice holds a General Medical Services contract with NHS England. At the time of the inspection the practice has 3,111 registered patients. The practice has a higher proportion of registered patients aged 20-29 years old, 619 patients (20%) and 30 to 39 years old, 653 patients (21%) which is a different demographic to the average patient age range within the local CCG. For example, the percentage of patients aged 65 and above at Whitehall Medical Practice is 7% compared to the local CCG practice average of 24% and the national practice average of 17%. The percentage of registered patients from ethnic minorities is 2.21% which includes Polish, Asian and African decent patients.

Whitehall Medical Practice is located in Shrewsbury. The practice opened as the Shropshire walk in centre in September 2009 and originally provided a practice for registered patients with a walk in service. The walk in centre moved in December 2014 to the Urgent Care Centre based at the Royal Shrewsbury hospital and Whitehall Medical Practice remained and continues to grow its patient list.

The practice treatment areas and consulting rooms are on the ground floor. As well as providing the contracted range of primary medical services, the practice provides additional services including:

• Minor surgery

• Venepuncture (blood sample taking)

The practice is open each weekday from 8am to 6.30pm.The practice has opted out of providing cover to patients outside of normal working hours. These out-of-hours services are provided by Shropdoc.

There are 14 permanent staff in total, working a mixture of full and part times hours. Staff at the practice include:

• Four salaried GPs (two male and two female) providing 1.6 whole time equivalent (WTE) GP hours.

• A full time Practice Manager

• An advanced nurse practitioner, two practice nurses and a healthcare assistant, providing 2.6 WTE hours.

• Three reception staff, a Data Summariser and Quality Outcomes Framework lead, and a secretary providing 3.45 WTE hours.

The provider is aware that a registered manager application is required for Whitehall Medical Practice and for the former registered manager needs to deregister. The practice informed the Care Quality Commission that applications were in the process of being made.

Updated 25 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Whitehall Medical Practice on 5 July 2016. Overall the practice is rated as good.

Our key findings 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 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 GP 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 local 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.

There were also areas of practice where the provider should make improvements:

• Improve staff awareness in the use of the practice hearing loop system for patients who may require this aid.

• Maintain full recruitment records at the practice on locum GPs and ensure that these are requested from the agencies used.

• Improve the practices approach to Medicines and Healthcare products Regulatory Agency (MHRA) alert findings.

• Carry out regular checks on all patients prescribed high risk medicines.

• Introduce a systematic approach to monitor patient outcomes and the number and type of minor surgical procedures undertaken.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 August 2016

The practice is rated as good in the care of people with long-term conditions.

• Patients at the highest risk of unplanned hospital admissions were identified and care plans had been implemented to meet their health and care needs.
• 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 medicines needs were being met. For people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

• The practice involved the patients carer where consented to do so in their medicines management reviews.

• Nursing staff had lead roles in chronic disease management and had undertaken additional training. For example, a practice nurse with specialist diabetic nurse training supported diabetes patients with dietary advice, referred patients to a structured education program, foot screening service and retinal screening service when they were first diagnosed.

Updated 25 August 2016

The practice is rated as good in 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 83% which was comparable with the local CCG average of 83% and national average of 82%.

Updated 25 August 2016

The practice is rated as good in the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population. They were responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• The practice care coordinator provided patients with non-clinical support coordinating with other organisations such as district nurses, physiotherapists and charity and other voluntary organisations.

Updated 25 August 2016

The practice is rated as good in the care of working-age people (including those recently retired and students).

• The practice offered telephone appointments with the GPs and the Advance Nurse Practitioner and these were also bookable for working patients unable to attend the practice.

• The practice provided online services to enable patients to book appointments, order repeat medicines and access some parts of their health records online.

• The practice provided appointment reminder text messages.

• Health promotion and screening services reflected the health needs of this group.

Updated 25 August 2016

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

• Performance for poor mental health indicators was slightly higher than the national averages. For example, 100% of patients with enduring mental health had a recent comprehensive care plan in place compared with the CCG average of 89% and national average of 88%.

• Staff had a good understanding of how to support patients with mental health needs and dementia. For example the percentage of patients with dementia care plans on their dementia register was 100%.

Updated 25 August 2016

The practice is rated as good in the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including known vulnerable adults, those who were housebound and patients with a learning disability.

• The practice involved the patients carer where consented to do so in their medicines management reviews.

• 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.

• The practice held a register of the practices’ frail and vulnerable patients and had identified patients who may be at risk of unplanned hospital admissions.

• The care co-ordinator supported patients and signposted to other allied health and social care professionals, voluntary agencies and charitable agencies when required.