Archived: The Whalebridge Practice

Updated 17 December 2015

The Whalebridge Practice is situated in the town centre area of Swindon, Wiltshire. The practice has approximately 9,700 registered patients across a large area of Swindon. The practice is located in premises which are shared with another GP practice and a GP walk in service. Other community healthcare services are also based in the same building. The practice has four consulting rooms and two treatment rooms. The practice is on a primary medical service contract with the Swindon Clinical Commissioning Group.

The Whalebridge Practice is only provided from one location:

The Whalebridge Practice

Health Centre

Carfax Street

Swindon

Wiltshire

SN1 1ED

The practice supported patients from all the population groups: older people; people with long-term conditions; mothers, babies, children and young people; working-age population and those recently retired; people in vulnerable circumstances who may have poor access to primary care; and people experiencing poor mental health.

Over 44% of patients registered with the practice were working aged from 15 to 44 years, 25% were aged from 45 to 64 years old. Just above 14% were over 65 years old and 16% were less than 14 years of age. Information from the Swindon Clinical Commissioning Group (CCG) showed that 52% of the patients had long standing health conditions, which was similar to the national average of 53%. The percentage of patients who had caring responsibilities was 11% and 7.9% of the working population were unemployed.

There were three GP partners, all male. Three practice nurses and one healthcare assistant provided health screening and treatment five days a week. Additional clinics were available occasionally to meet specific needs such as influenza vaccinations. The GPs were available for routine surgeries between the hours of 8am and 6.30pm Monday to Friday. Early morning appointments were available on request from 07:00 to 08:00.

The practice referred patients to another provider for an Out-of-Hours service to deal with any urgent needs when the practice was closed.

Updated 17 December 2015

Letter from the Chief Inspector of General Practice

We carried out a focussed inspection of The Whalebridge Practice, Health Centre, Carfax Street, Swindon, SN1 1ED.

Our previous inspection on 10 October 2014 found breaches of regulations relating to the safe delivery of services. We found the practice was inadequate for the provision of safe services and was rated as requiring improvement for effective and well led services. Caring and responsive service provision was rated as good. Overall the practice was rated as one which required improvement.

We found during this inspection that the practice was meeting the regulations that had previously been breached and had taken action in relation to safe service provision. These areas related to infection control, safe management of medicines and the safe arrangements for responding to a medical emergency.

This report only covers our findings in relation to those areas in which were inadequate or required improvement. These areas were identified within our last inspection report. .You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Whalebridge Practice on our website at www.cqc.org.uk.

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

• Vaccines and liquid nitrogen were stored securely. There were systems in place to monitor and record the temperatures of all refrigerators containing medicines and vaccines.
• There was a planned approach to clinical audits which led to changes in the care and treatment provided to patients.
• The systems for the management of infection control were carried out effectively.
• The training needs of staff were identified, planned and delivered.
• A risk assessment process for the arrangements for responding to medical emergencies and for accessing resuscitation equipment was in place, reviewed and actions implemented to ensure a safe system.
• A risk assessment was regularly carried out and actions put in place in regard to ensuring safe access arrangements for patients to the practice building and facilities.

We have amended the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe, effective, caring, responsive and well led services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 5 February 2015

Each patient was seen by a GP as part of the registration process and if further tests and screening were needed, such as joining the on-going monitoring for long-term health conditions like diabetes and high blood pressure, these were arranged.

We found patients’ long-term conditions were monitored effectively using the information from the Quality and Outcomes Framework (QOF) data for 2012/2013. The long-term conditions included asthma, coronary heart disease and diabetes. The GP and nursing team had a particular interest in patient with diabetes. Staff had identified patients from a particular ethnic group who were at greater risk for developing diabetes. Patients from this ethnic group were systematically screened when they registered or when they attended the practice.

Patients were directed to other providers and external support groups for additional help and support for long terms conditions such as stroke and dementia.

Updated 5 February 2015

The practice is rated as good for the population group of families, children and young people.

There was multidisciplinary working for mothers and babies for post natal checks and first immunisation. The midwives worked with the GPs and practice nurses to ensure that post natal checks including mental health occurred at eight weeks so that new mothers could attend and their babies could receive their immunisations at the same time. We were told midwives had experienced their opinions on patients care needs were listened to and acted upon by the GPs.

Staff ensured that they had a flexible approach to providing support to patients such as offering influenza vaccinations on a Saturday to meet the needs of families.

Updated 5 February 2015

The practice is rated as good for the care of older people.  Nationally reported data showed the practice had good outcomes for conditions commonly found amongst older people.  The practice was responsive to the needs of older people, including offering home visits and rapid access appointments for those with enhanced needs and home visits.

The practice offered on-going care and support for older people. Information from patients showed they had experienced treatment in a caring way from staff and they were satisfied with the support they had.

The location of the practice presented a challenge to some patients who we observed to walk into the wrong service. The signage for the building did not meet good practice recommendations for those who had sight impairments or dementia. The central patient waiting area was cramped and we observed during morning surgery that there was limited space for patients to get past each other, there and in adjacent corridors.

The passenger lift which was shared with the other services on the first floor of the building was small and the lighting was poor. We observed patients with wheelchairs and mobility scooters had difficulty negotiating the lift.

Patients were referred to the memory clinic and other services at the local hospital which were specifically for patients with dementia.

Updated 5 February 2015

The practice is rated as good for the population group of the 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 offer continuity of care. The practice offered a range of health promotion and screening which reflected the needs for this age group.

The practice had a flexible approach to providing appointments and access to services for patients who were not able to attend during usual working hours. There were opportunities for early morning booked appointments so that patients who worked could attend.  

The practice offered well person checks for the working age population which looked at patients’ cardiovascular health. There were targeted health concerns that patients were alerted to and encouraged to attend screening for such as testicular cancer. Staff offered influenza vaccinations at lunch time and on a Saturday to meet the needs of working people.

Updated 5 February 2015

The practice is rated as good for the population group of people experiencing poor mental health (including people with dementia). 82% of people experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health including those with dementia. The practice had in place advance care planning for patients with dementia.                    

The practice had sign-posted patients experiencing poor mental health to various support groups and third sector organisations. The practice had a system in place to follow up on patients who had attended accident and emergency where there may have been mental health needs.

The practice provided support to patients with a variety of mental health needs, including depression, dementia and poor mental health. Patients were assessed and had on-going reviews, with additional support from other professionals. The practice offered counselling services to patients which they could refer themselves without seeing a GP.

Patients with dementia and their carers were directed for more specific access to external support from other organisations.

Updated 5 February 2015

The practice is rated as good for the population group of people whose circumstances may make them vulnerable. The practice had sign-posted vulnerable patients to various support groups and third sector 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 and out of hours.  

The practice partners told us they worked in collaboration with the drug and alcohol service for the medical care of people who were drug or alcohol dependent.