Background to this inspection
Updated
11 June 2015
Cowgill Surgery is situated within a purpose built surgery in Bradford.
The practice provides Personal Medical Services (PMS) for 3988 patients under a contract with NHS Bradford Districts Clinical Commissioning Group (CCG).
There are two GP partners, male and female, although one has recently retired and the practice manager is also a partner. There are also three salaried GPs, one male and two female. The clinical team includes a team of two practice nurses and a phlebotomist. An experienced team of management, administrative and reception staff support the practice. This practice is part of a group of four practices who share administration functions and the administration team were undergoing changes to their roles at the time of the inspection.
The practice opening times are Monday to Friday 8 am to 6 pm and there are extended opening hours on a Friday morning from 7am to 8.00am. Pre-bookable appointments with a GP were only available for the extended hour’s appointments on Friday mornings. The other GP surgeries ran as drop in sessions between 8.00 am to 10.00 am and 3 pm to 5.30 pm.
Local Care Direct provides services between 6 pm and 6.30 pm and is accessed via the practice telephone number. Calls to the practice are automatically redirected to this service outside of the practice opening hours. Between 6.30 pm and 8 am out of hours services were accessible by calling 111.
The practice is registered to provide the following regulated activities; family planning, diagnostic and screening procedures, maternity and midwifery services, surgical procedures and treatment of disease, disorder or injury.
Updated
11 June 2015
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Cowgill Surgery on 24 February 2015. Overall the practice is rated as good.
Specifically, we found the practice to be good for providing safe, well-led, effective, caring and responsive services. It was also rated as good for providing services for all population groups.
Our key findings across all the areas we inspected were as follows:
- Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
- Risks to patients were assessed and well managed.
- Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
- 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 was available and easy to understand.
- Patients said they found the appointment system very accessible.
- 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.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
11 June 2015
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 and monitored. Home visits were available when needed. All these patients had a named GP and a structured annual review to check their health and medication needs were being met. For those people with the most complex needs, the practice worked with relevant health and care professionals to monitor patient outcomes and to deliver a multidisciplinary package of care. An advanced nurse practitioner had been employed to support patients with complex needs. The practice held a number of in-house clinics to support this group of patients such as warfarin monitoring and in house electrocardiogram (ECG) appointments.
Families, children and young people
Updated
11 June 2015
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 who were at risk, Appointments were available outside of school hours and the premises were suitable for children and babies. The practice worked closely with other agencies such as the health visitors and held a number of in-house health and social care clinics. The practice provided care for a local college and had a good understanding of the particular need of this group. They provided flexible services to ensure the cultural and religious needs of this group were met.
Updated
11 June 2015
The practice is rated as good for the care of older people. Nationally reported data showed outcomes for patients were good for conditions commonly found in older people. All patients over 75 years of age had a named GP. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits. Regular visits to local nursing homes were also undertaken. Monthly multi-disciplinary meetings were held to review the care needs of older people. The practice worked closely with other health and social care organisations such as the integrated care team and ran a number of in-house clinics.
Working age people (including those recently retired and students)
Updated
11 June 2015
The practice is rated as good for the care of working-age people (including those recently retired and students). The services offered ensured appointments were accessible, flexible and offered continuity of care. Drop in GP sessions, telephone consultations and pre-bookable early morning appointments were all available to this group of patients.
The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group. A number of specialist clinics were also available in-house.
People experiencing poor mental health (including people with dementia)
Updated
11 June 2015
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). People experiencing poor mental health received an annual physical health check and longer appointments were available. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out pre-screening and care planning for patients with dementia.
The practice had told patients experiencing poor mental health about how to access various support groups and held in-house clinics.
People whose circumstances may make them vulnerable
Updated
11 June 2015
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. It offered longer appointments for people with a learning disability.
The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It signposted vulnerable patients 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 held a number of in-house health and social care clinics to support patients such as, health trainer clinics.