LONGROYDE SURGERY

Updated 19 August 2016

Longroyde Surgery is situated in Brighouse, Calderdale HD6 3HT. It is housed in a purpose built single storey building. Car parking is available on site. There are currently 3990 patients on the practice list. The majority of patients are of white British ethnicity, with a small percentage of other white, black Afro-Caribbean and South Asian ethnicities. The practice provides General Medical Services (GMS) under a locally agreed contract with NHS England. They offer a range of enhanced services such as childhood immunisations, contraception services and cryotherapy. Cryotherapy is a process whereby skin lesions are removed by use of extremely cold temperatures.

The practice has three GP partners, two of whom are female and one male. One of the GP partners is the Chair of the local CCG. The clinical team is completed by two practice nurses, both of whom are female. The clinical team is supported by a practice manager, and a range of administrative and reception staff.

The practice catchment area is classed as being within one of the less deprived areas of England. The practice profile shows a slightly higher than average number of patients in the 40 to 54 year age group. The average life expectancy of patients in the practice is 78 years for men and 82 years for women (CCG average 77 and 82 respectively and national average 79 and 83 respectively).

The practice is open between 8.30 am and 6.30pm Monday to Friday.

Regular clinics are held which include monthly diabetes, podiatry and epilepsy clinics. 

Out of hours care is provided by Local Care Direct which is accessed by calling the surgery telephone number, or by calling NHS 111 service.

Updated 19 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Longroyde Surgery on 28 June 2016. Overall the practice is rated as good.

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

• The practice had an open and transparent approach to safety. There was an effective system in place for reporting, recording and reviewing 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 the skills, knowledge and experience to deliver effective care and treatment.
• Patients consistently said they were treated with compassion, dignity and respect and they were treated as partners in planning their care and making decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to access the surgery by telephone. They found it easy to make an appointment with a named GP. This meant there was continuity of care. Urgent appointments were available the same day. Routine appointments could be booked up to 12 weeks in advance
• The practice had some limitations with regards to space. However they made good use of the facilities available to them. They were 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.

We saw areas of outstanding practice:

• The practice was proactive in identifying carers on their practice list. At the time of our visit 4% of their patients had been identified as unpaid carers. Calderdale Carers offered additional support and information to this group of patients

• Patient satisfaction survey results consistently rated the practice higher than local and national averages with respect to access to appointments and all aspects of care provided by the practice. On the day of our inspection we received overwhelmingly positive comments from patients who spoke with us in person, as well as those patients who had completed comment cards prior to our visit.

• The practice had systems in place which enabled them to achieve 100% attendance for 6-8 week medical checks for new babies.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 August 2016

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

• 93% of patients on the diabetes register had a recorded foot examination completed within the preceding 12 months which was higher than the local average of 89% and the national average of 88%.

• Patients were offered annual reviews of their long term condition. They received a 20 minute appointment with the nurse. Patients with more than one long term condition had all their needs reviewed in one appointment.

• The practice made use of a care planning approach for a number of long term conditions, to encourage patient involvement in management of their condition.

• The GPs carried out regular polypharmacy reviews. (Polypharmacy is a term used for patients taking 10 or more medicines).  Patients identified as requiring a face to face consultation were then invited to an appointment with their GP to discuss their medication needs.

• Patients could be referred to the ‘Better Living Team’ who helped with weight management and individualised exercise programmes.

• The practice was able to refer patients to a locally run pain management group to help patients living with chronic pain to manage their condition.

• The practice provided evidence to show that they had improved the management of patients with diabetes by utilising the skills of the local diabetes specialist nurse.

• The practice participated in a local pulmonary rehabilitation programme, and showed us evidence that the number of referrals to this programme had more than doubled during a 12 month pilot.

Updated 19 August 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 accident and emergency ( A&E ) attendances. Immunisation rates were relatively high for all standard childhood immunisations.

• 88% of patients with asthma, on the register had received a review in the preceding 12 months which was higher than the local average of 76% and the national average of 75%.

• Staff told us that children and young people were treated in an age appropriate way.

• Appointments were available outside of school hours and the premises were suitable for children and babies. Baby changing facilities were available. Mothers wishing to breastfeed their babies were offered a private room in which to do so.

• The practice ran a weekly baby clinic, attended by the  health visitor and supported by a practice nurse and GP. Babies received a 6- 8 week medical  and immunisation at this appointment, and maternal emotional well-being was reviewed by the health visitor. The practice  provided evidence that they achieved 100% attendance for this appointment by telephoning parents on the day to remind them about their appointment.

• The practice liaised informally with the health visitor during her weekly ' drop in' baby clinic at the practice. Formal minuted meetings were held eight weekly with the link health visitor for the practice where children who had more complex needs were discussed. At the time of our visit five children were subject to a child in need plan and three were subject to a child protection plan. These are plans which formalise how social care, health and other professionals work together to protect children. We heard examples of how joint working with health visitors had been effective.

Updated 19 August 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 had identified their 2% of patients at higher risk of unplanned admissions, and had developed comprehensive care plans to manage the needs of this group of patients.

• Before the inspection we sought feedback from two nursing homes that had residents registered at the practice. They both told us they received a high standard of responsive, caring and efficient care from the practice

Updated 19 August 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.
• 91% of eligible women had a recorded cervical smear completed within the preceding five years which was higher than the local average of 85% and the national average of 82%.
• Appointments could be booked up to 12 weeks in advance for routine appointments
• Appointments were available at the end of the afternoon session, up to 6.20pm for working age people who required an urgent appointment. The practice told us surgeries could be extended to accommodate all patients requiring on the day appointments.
• The practice provided us with data which indicated that most consultations were held face to face, with only 6% of consultations being a telephone contact.

l

Updated 19 August 2016

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

• 86% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was higher than the local and national average of 84%.
• 97% of patients with schizophrenia or other psychoses had received a comprehensive care plan in the preceding 12 months which was higher than the local average of 90% and the national average of 88%.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• The practice carried out advance care planning for patients with dementia.
• The practice gave patients experiencing poor mental health information 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 liaised closely with the nursing homes where they had patients registered, to manage the needs of those patients who were subject to deprivation of liberty safeguards (DOLS) (These are safeguards which can be applied for by a care home or hospital and which seek to restrict the movement of people to keep them safe from harm when they have been found to lack capacity).

Updated 19 August 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.

• People with a learning disability were issued with a ‘VIP’ card. This provided details of preferred communication methods for the patient, and gave details of key persons involved in their support, such as their carers. The VIP card could be used when patients accessed services in hospital or other outpatient clinics. This group of patients were also issued with a 'Patient Health Plan' which provided personalised information relating to healthcare needs and preferences.

• The practice offered longer appointments for patients with a learning disability when required.

• Patients with a learning disability received an annual medical review which included a 20 minute appointment with the nurse followed by a 20 minute appointment with the GP. All patients identified as having a learning disability were given a 'Patient Health Plan' which provided personalised details of current healthcare needs and preferences.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• The practice informed vulnerable patients  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.

• The practice had identified 146 patients in the practice who were unpaid carers. This group of people was offered an annual seasonal flu vaccination, and could be signposted to local support groups, such as Calderdale Carers