Church Lane Surgery

Updated 18 February 2016

Church Lane Surgery is located in Brighouse, Calderdale.. The practice has a list size of 11 991 patients. Most of their patients are white British, with a small percentage of South Asian, Eastern European and patients of other 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 and extended opening hours.

There are seven GPs, four of whom are male and three female. The practice is also staffed by two practice nurses (both female) and three health care assistants (HCA) all of whom are female. The clinical team is supported by a practice manager, operations manager, reception manager and a range of reception and administrative staff. The practice is a teaching practice which means it offers General Practice experience to medical students and recently qualified doctors.

The practice is classed as being within one of the least deprived areas in England. The practice has a higher than average proportion of patients over the age of 66 years.

The practice is open between 8am and 6.30pm Monday to Friday. Extended opening hours are available by appointment only on Tuesday until 8pm, on Wednesday from 7am and on Thursday from 7am to 8pm.

The practice runs several clinics each week, including diabetic, asthma, well baby, family planning,family planning and substance misuse clinics.

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.

Church Lane Surgery is registered with the Care Quality Commission to provide treatment of disease, disorder or injury, diagnostic and screening procedures, surgical procedures, family planning and maternity and midwifery services.

Updated 18 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Church Lane Surgery on 7 January 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.
• Information about services and how to complain was available and easy to understand.
• Patients said they found the recently improved appointment system easier to book an appointment, though not necessarily with the GP of their choice. Continuity of care was delivered as GPs booked any necessary follow ups with the patient at the time of their initial appointment. Most appointments were available on the same day.
• The practice was making good use of the facilities available to them and tailored services to best meet patient needs.
• There was a clear leadership structure and staff felt supported by management
• The practice proactively sought feedback from patients and staff; and acted upon this feedback.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw one area of outstanding practice:

• The practice ran an in-house Shared Care service offering support for opiate users. This service was provided by a dedicated GP who was supported by a drugs keyworker and by input from WYFI (West Yorkshire Finding Independence) service.Patients registered at practices other than Church Lane Surgery were able to access this service.The practice demonstrated that this service was able to provide a wide range of services to local people and prevented them from needing to access city centre substance misues services.

However there were areas where the provider needs to make improvements. Specifically the provider should:

• Complete an annual infection prevention and control (IPC) audit and ensure any identified actions are completed.

• Complete annual appraisals for all staff

• Establish regular multidisciplinary (MDT) meetings which are minuted.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 February 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.

• The percentage of patients with diabetes on the register who had received influenza immunisation in the preceding year was 97% which was higher than the national average of 93%.

• The practice participated in the CCG wide level three diabetes service which sought to manage stable insulin dependent patients within primary care.

• 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 18 February 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.

• Data showed that 82% of eligible women had completed a cervical screening test in the preceding five years which was the same as the national average.

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

The practice had weekly input from the health visiting team during a baby clinic. This enabled GPs and health visitors to liaise with regard to families and children of concern. The practice was planning to introduce a more formal meeting to discuss any relevant issues

Updated 18 February 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 older people, and offered home visits and urgent appointments for those with enhanced needs.

• The practice offered annual health checks on patients over 75 years. We saw evidence that 54% of those patients invited had received the intervention.

• All patients over 75 had a named GP.

Before the inspection we sought feedback from a local nursing home whose residents were registered with the practice and found they were happy with the service provided to their residents

Updated 18 February 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. Data showed 76.1% of eligible women had been screened for breast cancer within six months of invitation compared to a CCG average of 69.5% and a national average of 73.2%.

• 30% of eligible patients had accessed the NHS cardiovascular health check.

Updated 18 February 2016

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

• 77% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months.

• 92% of people with schizophrenia or other psychoses had a comprehensive agreed care plan documented in the last 12 months.

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

• It 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.

• It 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 people with mental health needs and dementia

Updated 18 February 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 who were substance misusers and those with a learning disability.

• It offered longer appointments for people with a learning disability.

• The practice regularly worked with multidisciplinary teams in the case management of vulnerable people. For example they worked with WYFI (West Yorkshire Finding Independence) which was a lottery funded organisation offering additional support to homeless people and those with drug and alcohol problems.

• It gave vulnerable patients information about how to access relevant support groups and voluntary organisations.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities and gave good examples to demonstrate how they shared information and documented safeguarding concerns. They knew how to contact relevant agencies in normal working hours and out of hours.