Background to this inspection
Updated
14 December 2016
The Alverthorpe Surgery is located on Balne Lane, Wakefield, West Yorkshire, WF2 0PD, and provides services for 2,655 patients.
The surgery is situated within the Wakefield Clinical Commissioning Group (CCG). The surgery provides services under the terms of a personal medical services (PMS) contract. This is a contract between general practices and NHS England for delivering services to the local community.
There is a higher than average number of patients between the ages of 45 and 74 years. The practice provides services for a predominantly white British and Irish (72%) with a smaller number of patients from Asian (10%), Eastern European (6%), Middle Eastern (4%) and Afro-Caribbean (8%) backgrounds.
There is a male lead GP who is supported by two locum GPs (male). The practice also has a female practice nurse. Although there was no female GP at the practice, patients had access to a chaperone. The clinical team is supported by a practice manager and a team of administrative staff.
The practice catchment area is classed as being within one of the fourth most deprived areas in England. People living in more deprived areas tend to have a greater need for health services.
Alverthorpe Surgery is situated within a single storey purpose built building with car parking available. It has disabled access and facilities.
The practice is open from 8am until 6.30pm from Monday to Friday, with a range of appointments being offered between these hours.
When the practice is closed out-of-hours services are provided by Local Care Direct, which can be accessed via the surgery telephone number or by calling the NHS 111 service.
Updated
14 December 2016
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Alverthorpe Surgery on 28 June 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.
- 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 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.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
14 December 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.
- Outcomes for diabetes related indicators were comparable or better than other practices. For example the percentage of patients on the register who had a flu immunisation in the preceding 12 months was 100% compared to the CCG average of 97% and national average of 94%.
- 91% of patients with diabetes, on the register, had a record of a foot examination and risk classification, compared to the CCG average of 89% and national averages of 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 used a risk stratification tool to aid management of diabetes and coronary heart disease. This aimed to improve consistency, quality and effectiveness of patient care at the point of care.
Families, children and young people
Updated
14 December 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 offered dedicated appointments for children/young people and these could be accessed in person or via a telephone clinic. The practice nurse was also available during these sessions for any patient preferring to speak to a female member of staff.
- The practice worked closely with the local youth project and involved them in reviewing the practice website and producing a survey aimed at younger patients.
- The percentage of eligible women, who had undergone a cervical screening test in the preceding five years, was 91% which was better than the CCG average of 84% and the national average of 82%.
- Appointments were available outside of school hours and the premises were suitable for children and babies.
- We saw positive examples of joint working with midwives, health visitors and school nurses.
Updated
14 December 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 worked alongside Age UK and the local Health and Wellbeing Team to promote groups and services available.
Working age people (including those recently retired and students)
Updated
14 December 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 were part of a local hub of practices who offered patient appointments from 6.30pm until 8pm each weekday and from 9am until 3pm on Saturdays.
- The practice offered a range of online services including booking appointments and repeat prescription requests.
People experiencing poor mental health (including people with dementia)
Updated
14 December 2016
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).
- 100% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which was better than the CCG average of 83% and national average of 84%.
- 100% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive care plan documented in their record, in the preceding 12 months. This was better than the CCG average of 90% and national average of 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.
- The practice used a risk stratification tool to aid identification and management of dementia. This aimed to improve consistency, quality and effectiveness of patient care at the point of care.
People whose circumstances may make them vulnerable
Updated
14 December 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 or multiple appointments for patients with a learning disability.
- The practice had a system in place to follow up patients who did not attend their appointment.
- 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.