Background to this inspection
Updated
3 October 2018
Primrose Surgery is situated within Hillside Bridge Health Care Centre, 4 Butler Street West, Bradford, BD3 0BS. The surgery has good transport links and there is a pharmacy located within the health centre. The practice provides fully accessible facilities and all services are accessible via a lift. The practice has ample car parking.
Primrose Surgery is situated within the Bradford City Clinical Commissioning Group (CCG) and provides services to 5,232 patients under the terms of a personal medical services (PMS) contract.
This is a
contract between general practices and NHS Bradford City CCG for the delivery of
services to the local community.
Primrose Surgery is registered to provide the regulated activities of diagnostic and screening procedures, treatment of disease, disorder or injury, and maternity and midwifery services.
There are two male GP partners at the practice, a full-time locum advanced nurse practitioner, a part time practice nurse and a healthcare assistant (HCA) all of whom are female. The practice also has a part time pharmacist who works four hours per week. The practice used the services of locum clinicians as necessary.
There is a higher than average number of patients under the age of 39, in common with the characteristics of the Bradford city area, and fewer patients aged over 45 than the national average. The National General Practice Profile states that 73% of the practice population is from an Asian background with a further 8% of the population originating from black, mixed or other non-white ethnic groups.
Information published by Public Health England rates the level of deprivation within the practice population group as one, on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. Male life expectancy is 73 years compared to the national average of 79 years. Female life expectancy is 78 years compared to the national average of 83 years. Nationally, the average number of times a person visits their GP in a year is five. CCG statistics show that in Bradford City the average number of visits is between nine and 11. People living in more deprived areas tend to have a greater need for health services.
Primrose Surgery is open between 8am and 6pm Monday to Friday with GP appointments available between 9am and 5pm. The practice is part of an alliance which provides appointments with a number of clinicians including GPs, physiotherapists and wellbeing workers, between 6.30pm and 9pm Monday to Friday and from 10am until 1pm on a weekend. The service is delivered from three different sites across the city.
Between 6pm and 6.30pm Monday to Friday care was provided by contractual arrangements with another provider. Out of hours care is accessed by calling the NHS 111service.
During our inspection we saw that the provider was displaying the previously awarded ratings on the practice premises, and on their website.
Updated
3 October 2018
This practice is rated as Good overall.
(A previous inspection undertaken on 9 November 2017 had rated the practice as requires improvement overall.)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Good
We carried out an announced comprehensive inspection at Primrose Surgery on 9 November 2017. The overall rating for the practice at that time was requires improvement. The full comprehensive report on the November 2017 inspection can be found by selecting the ‘all reports’ link for Primrose Surgery on our website at
www.cqc.org.uk.
This inspection was an announced comprehensive inspection carried out on 23 August 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach of regulations, that we identified in our previous inspection on 9 November 2017. This report covers our findings in relation to those requirements and additional improvements made since our last inspection.
At this inspection we found:
- The practice had addressed all issues and areas of concern, which had been identified at the previous inspection.
- There was evidence of good management and clinical leadership, which was supported by organised systems and processes.
- There were noteworthy improvements in the reporting, recording and discussion of significant events. We saw evidence of learning from events and that action was taken to prevent the same thing happening again.
- There was a clear process for dealing with complaints. All complaints to the practice were recorded and reviewed with the staff team.
- There was regular staff engagement, through the use of appraisals and mentorship. The practice had introduced task lists for non-clinical staff which enabled leaders to undertake a weekly review of progress and target support for staff when needed.
- There was evidence of good patient engagement, through the use of the patient participation group, a practice patient survey and engagement with the community.
- The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
- On the day of inspection patients told us they found the appointment system easy to use and were very happy with the care and treatment they received.
- There was a renewed focus on support, development and continual improvement at all levels of the organisation.
We saw areas of outstanding practice:
- In response to a significant event in another area, the practice had developed ‘grab cards’ for clinical and non-clinical staff to be used in the event of an emergency. The cards detailed the action that each responding member of staff would take to manage the emergency efficiently. Alongside this; we saw that the emergency equipment was clearly labelled with large numbers which corresponded to charts displayed throughout the practice. This meant that in stressful emergency situations, non-clinical or unfamiliar staff could be directed to collect a piece of emergency equipment, regardless of their knowledge of what that equipment looked like.
- The practice had introduced a dedicated pain management clinic in response to initiatives to reduce the prescription of pain medications. The consultations focused on enabling self-management of pain using alternatives to medications and also health promotion, using various resources like leaflets, social prescribing and websites.
The areas where the provider should make improvements are:
- The provider should continue to review and take steps to improve the uptake of cancer screening at the practice, including bowel, breast and cervical screening.
- The provider should review and improve their arrangements for patients who may wish to see a female GP.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice.