Keighley Road Surgery

Updated 23 March 2016

Keighley Road Surgery is situated in Illingworth, Calderdale. Illingworth is a village situated approximately three miles north west of Halifax. It is housed in purpose built single storey premises. The practice has a patient list of 10,539. Most of their patients (96%) are of White British origin. The practice catchment area encompasses urban and semi-rural areas. The practice provides General Medical Services (GMS) under a locally agreed contract with NHS England. They offer a range of enhanced services, such as extended hours, minor surgical procedures and childhool vaccination and immunisation.

There are three GPs, one female and two male. Pending the recruitment of a fourth GP partner the practice is being supported by two female locum GPs. There are three advanced nurse practitioners, four practice nurses and two health care assistants (HCA). Pharmacy support is provided by three pharmacists, whose role is to offer medicines management and prescribing support to the clinical team. The clinical team is supported by a practice business manager, three administration managers and a range of administrative, reception and cleaning staff. The practice is a teaching practice, which means it supports the training of qualified doctors wishing to become General Practitioners. It also provides placement opportunities for student nurses in training, and runs an apprenticeship scheme for practice administration.

The practice had been through significant staffing changes in the previous 18 months, when four GP partners and the practice manager had left the practice or retired. There were plans in place to augment the clinical team by the recruitment of a fourth GP partner.

The practice is classed as being within the group of the more deprived areas in England. The age profile of the practice is comparable to national averages.

Keighley Road Surgery is open between 8am and 6.30pm Monday to Friday. The practice also opens Saturday between 9am and 12pm. Several clinics are held each week including child immunisations, family planning and sexual health, asthma/COPD and diabetes.

Out of hours cover is provided by Local Care Direct and is accessed via the surgery telephone number or by calling the NHS 111 service.

Keighley Road Surgery is situated on Keighley Road, Illingworth, Halifax HX2 9LL.

Updated 23 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Keighley Road Surgery on 16 February 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 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.

• Patient Champions had been established to develop innovative services aimed at improving the health and well-being of the practice population.

• Information about services and how to complain was available and easy to understand.

• Patients said they found it easy to make an appointment with a GP or nurse practitioner and that there was continuity of care, with urgent appointments available the same day.

• The practice made good use of the facilities available to them and was 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 the following examples of outstanding practice:

• The practice business manager had been instrumental in setting up the local ‘Pennine GP Alliance’ which was established to facilitate collaboration between local practices in innovating and improving services to local people.

• One of the nurse practitioners had led on setting up a local nurse practitioner forum which had implemented changes in the scope of the nurse practitioner role. These changes had been adopted by all practices in Calderdale and was being extended to the Kirklees practices.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 March 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. Children with diabetes had been included in this group of patients.

• A case finding exercise had been carried out to identify those patients at risk of developing chronic obstructive pulmonary disease (COPD), a lung condition which causes difficulty with breathing. This group of patients were offered early assessment and intervention to help manage any symptoms.

• Patient Champions ran a series of healthy walks which started at the surgery. These walks varied in distance to suit a variety of patient needs and encouraged safe physical activity.

• Data showed that 82% of patients on the diabetes register had a cholesterol recording within normal range compared with 81% nationally.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 23 March 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.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and staff gave examples from practice which confirmed this.

• Appointments were available outside of school hours and on Saturday mornings, and the premises were suitable for children and babies.

• Staff provided us with good examples where joint working with midwives, health visitors and school nurses had been effective.

Updated 23 March 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.

• It was responsive to the needs of their older patients, many of whom were housebound, and offered home visits and urgent appointments for those with enhanced needs.

• The practice provided us with data which showed that 61% of eligible people had received an over 75 year health check in the preceding year.

• Before the inspection we sought feedback from a nursing home who had residents registered at the practice.They told us they were very happy with the service provided by the practice.

Updated 23 March 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. For example appointments were available on Saturday morning with a GP, nurse practitioner, practice nurse or health care assistant.

• The practice was proactive in offering online services as well as a full range of health promotion and screening reflecting the needs of this age group.

• Data showed that 85% of eligible women had completed a cervical screening test within the preceding five years compared with 82% nationally.

Updated 23 March 2016

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

• 95% of patients with schizophrenia and other psychoses had had a comprehensive care plan documented in the preceding 12 months.compared to the national average of 90%

• 82% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the preceding 12 months compared to the national average of 84%

• The practice regularly worked with multidisciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

• Patients were able to access a counselling service in-house which was provided by the local Community Mental Health Team.

• 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.

• There were systems in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff showed they had a good understanding of how to recognise and support people with mental health needs and dementia.

Updated 23 March 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 and those with a learning disability.

• Longer appointments were offered for people with a learning disability.

• The practice regularly worked with multidisciplinary teams in the case management of vulnerable people.

• The practice participated in the ‘Staying Well’ project intended to help combat loneliness and social isolation.

• The practice gave good examples of how they had been able to support vulnerable people, for example by allowing access to practice washing and toilet facilities for a homeless patient over a period of several months and by offering support for patients fleeing domestic violence.

• Staff were aware of additional support services for vulnerable people and described how patients were signposted to these agencies.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were able to demonstrate their awareness of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.