Archived: Shawbirch Medical Centre

Updated 26 May 2016

Shawbirch Medical Centre is registered with the Care Quality Commission (CQC) as a partnership provider in Telford. The practice holds a General Medical Services (GMS) contract with NHS England. A GMS contract is a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract.

The practice area is one of low deprivation when compared with the national and local Clinical Commissioning Group (CCG) area. At the time of our inspection the practice had 11,660 patients. The practice has an age distribution greater in patients aged 40 – 54 years old but lower in patients aged 20 – 39 years old compared to the national and CCG area. The percentage of patients with a long-standing health condition is 52% which is slightly lower than the local CCG and national averages.The practice offers a variety of clinics such as smoking cessation, child health and sexual health clinics. It also offers clinics for patients with long term conditions such as asthma and diabetes. The practice is a training practice for GP registrars and medical students to gain experience and higher qualifications in general practice and family medicine.

The practice staffing comprises of:

• Five GP partners (four male and one female) and four salaried GPs and one GP registrar.
• Three female advanced nurse practitioners
• Three female practice nurses and two health care assistants
• A practice manager
• An assistant practice manager
• Members of reception / administrative staff working a range of hours.

The practice was open from 8am - 6pm Monday to Friday. The telephones were answered between 8.30am and 1.30pm and 2pm and 6pm. Appointments are available from 8am until 5.40pm and last 15 minutes. Extended surgery hours are offered every Tuesday between 6.30pm and 8pm and are by appointment only. The practice has opted out of providing cover to patients in the out-of-hours period. During this time services are provided by Shropdoc out of hours services. 

Updated 26 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Shawbirch Medical Practice on 2 March 2016. Overall the practice is rated as good.

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.
• Risks to patients were assessed and well managed.
• The staff assessed patients’ needs and delivered care in line with current evidence based guidance. The staff had 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.
• Patients told us they were able to get ‘on the day’ appointments when they needed them, although they did have to wait for a pre-bookable appointment with their GP of choice.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and the staff felt supported by the management. The GP partners had designated clinical and managerial lead roles.
• The practice proactively sought feedback from the staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.

However, there were also areas of practice where the provider should improvements.

The provider should:

• Ask applicants about any physical or mental health conditions they may have as part of the recruitment process.
• Review how the water temperatures are checked and recorded in line with the legionella risk assessment.
• Adopt a more proactive approach to identifying and meeting the needs of carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 26 May 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.
• The practice maintained registers of patients with long term conditions. Patients were offered a structured annual review to check their health and medicines needs were being met.
• Performance for diabetes related indicators were comparable to the national average. For example, the percentage of patients with diabetes, on the register, who had had influenza immunisation was 97% compared with the national average of 94%.
• Longer appointments and home visits were available when needed.
• 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 26 May 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 who were at risk, for example families with children in need or on children protection plans.
• Appointments were available outside of school hours and the premises were suitable for children and babies. Same day emergency appointments were available for children.
• There were screening and vaccination programmes in place and the practice’s immunisation rates
• Data from the Quality and Outcomes Framework (QOF) for 2014/2015 showed that 81% of women aged 25-64 had received a cervical screening test in the preceding five years. This was comparable to the national average of 82%.
• The practice ran a Women’s Health Clinic one day a week. Services included family planning and contraception services including implant/coil fitting.
• We saw positive examples of joint working with midwives and health visitors. Midwife clinics were held at the practice and bi-monthly meetings were held with the health visitor.

Updated 26 May 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 maintained a register of patients who were identified as elderly and vulnerable, and their care was discussed at monthly multi-disciplinary team meetings attended by the community matron and community nursing team.
• Older patients could be referred to the Age Concern Care Navigator for guidance on benefits and support available in the community.
• Regular monthly reviews of patients living in a local care home were carried out by the same GP for continuity of care.

Updated 26 May 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.
• Appointments were available from 8am through to 5.40pm.The practice also offered extended hours one evening a week, as well as telephone consultation and triage.
• 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.

Updated 26 May 2016

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

• Eighty-six percent of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average (84%).
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• The practice organised dedicated clinics to review the physical health needs and medicines for patients with mental health needs and those living with dementia. The practice had identified 73 patients with mental health needs and 74% had attended for their annual review.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• Counselling services were available at the practice.

Updated 26 May 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 those with a learning disability or identified as vulnerable.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• The staff knew how to recognise signs of abuse in vulnerable adults and children. The 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.