Archived: Duddon Valley Medical Practice

Updated 30 April 2015

Duddon Valley Medical Practice provides services to around 3,344 patients, from two locations, Kirkby Surgery, Askew Gate Kirkby-in- Furness, Cumbria LA17 7TE and Broughton Surgery, Foxfield Road, Broughton-in- Furness, Cumbria LA20 6EZ. The practice has a NHS General Medical Services contract. We visited both addresses as part of the inspection.

The practice has two GPs (a partner and a locum), three practice nurses, three dispensers, an administration manager, plus finance and administrative support team, six reception staff and a practice support and training consultant.

Opening times at Kirkby Surgery: 8.00am Monday, Wednesday, Thursday and Friday, plus early opening 7.30am Tuesday. Kirkby Surgery remains open every day up until 6.00pm apart from Thursday afternoon when it is closed between 1.00pm and 5.00pm, opening again up until 6.00pm 

Opening times at Broughton Surgery: 9.00am Monday, Wednesday, Thursday and Friday, plus early opening 7.30am Tuesday. Broughton remains open every day up until 5.00pm apart from Wednesday afternoon when it is closed from 12.30pm. 

Evening appointments are available at the Kirkby Surgery up until 5.30pm.

The practice has opted out of providing urgent medical attention out of hours to their own patients and this is provided by Cumbria Health On Call (CHOC) and the NHS 111 service.

The practice’s population includes fewer patients aged under 18 years, and slightly more patients aged over 65 years of age, than the averages for England.

The CQC intelligent monitoring placed the practice in band five. The intelligent monitoring tool draws on existing national data sources and includes indicators covering a range of GP practice activity and patient experience including the Quality Outcomes Framework (QOF) and the National Patient Survey. Based on indicators, each GP practice has been categorised into one of six priority bands, with band six representing the best performance band. This banding is not a judgement on the quality of care being given by the GP practice, this only comes after a CQC inspection has taken place.

Updated 30 April 2015

Letter from the Chief Inspector of General Practice

We carried out a planned comprehensive inspection of Duddon Valley Medical Practice on 25 November 2014.

Overall, we rated the practice as good. Our key findings were as follows:

• The practice covered a large geographical and rural area; services had been designed to meet the needs of the local population.
• We saw that the practice had made improvements which addressed the concerns we raised, at our inspection in May 2014, about supporting staff.
• Feedback from patients was positive; they told us staff treated them with respect and kindness.
• Staff reported feeling supported and able to voice any concerns or make suggestions for improvement.
• The practice was visibly clean and tidy.
• The practice learned from incidents and took action to prevent any recurrence.

We saw the following areas of outstanding practice:

The practice demonstrated effective leadership, outstanding teamwork and organisational resilience, for example the practice had improved itself despite going through a period of turbulence.

We saw that there was a high level of commitment to the practice by all the staff working there to care for their patients and each other. For example the practice was undergoing a full review of their policies and procedures. All staff were involved with this process, for instance, clinical staff had been asked to review their job descriptions to ensure they reflect the skills required to deliver the services provided from this small rural practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 30 April 2015

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

The practice had systems to ensure care was tailored to patients’ individual needs and circumstances. We spoke with GPs and nurses who told us regular patient care reviews, for example for patients with chronic obstructive pulmonary disease (COPD - severe shortness of breath caused by chronic bronchitis, emphysema, or both) or asthmatic conditions, took place. These appointments included a review of the effectiveness of patients’ medicines, as well as their general health and wellbeing. The practice ensured timely follow-up of patients with long-term conditions by adding them to the practice registers. Patients were then recalled as appropriate, in line with agreed recall intervals.

Updated 30 April 2015

The practice is rated as good for the care of families, children and young people.

The Community Midwife held antenatal clinics at the Kirkby Surgery. Systems were in place for identifying and following-up children who were considered to be at-risk of harm or neglect.

The practice undertook child immunisations. They also offered health checks every three years for patients over the age of 16 years which included discussing diet, smoking and exercise.

Appointments were available outside of school hours and the premises were suitable for children and babies. Arrangements had been made for new babies to receive the immunisations they needed.

Updated 30 April 2015

The practice is rated as good for the care of older people.

Nationally reported data showed the practice had good outcomes for conditions commonly found amongst older people. The practice offered personalised care to meet the needs of the older people in its population. The practice had written to patients over the age of 75 years to inform them who their named GP was. The practice was responsive to the needs of older people, including offering home visits and to those living in local care homes.

Updated 30 April 2015

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 aware that some patients found it difficult to attend appointments during the normal working day. To address this issue the practice had extended its opening hours on Tuesdays, offering appointments commencing at 7:30am from both Broughton and Kirkby Surgery sites.

Updated 30 April 2015

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

Patients experiencing poor mental health had received an annual physical health check. The practice worked closely with multidisciplinary teams such as the Crisis Team in the case management of people experiencing poor mental health. For patients with dementia their care had been reviewed in a face-to-face appointment in the preceding 12 months.

For patients with certain long-term conditions the practice had systems in place that automatically alerted staff to screen for depression.

Updated 30 April 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

Systems were in place to identify patients, families and children who were at risk or vulnerable. These patients were offered regular reviews. The practice worked in collaboration with other agencies, for example, health visitors and district nurses, to ensure vulnerable families and children and other patients were safe. Multidisciplinary meetings were also held regularly to monitor the care provided. The practice worked with patients being treated for addictions and provided personalised support.

The practice sign-posted vulnerable patients to various support groups and other relevant organisations. Staff knew how to recognise signs of abuse in vulnerable adults and children and were aware of their responsibilities to ensure they were safeguarded.