Archived: The Pendle Medical Partnership Also known as Earby Surgery

Updated 24 June 2016

Drs. Sangster, Huxley, Horsfield & Smith also known as the Earby surgery is based in the centre of Earby and is part of the East Lancashire Clinical Commissioning Group (CCG). It provides a service to patients in the West Craven, Colne and Barrowford areas. The practice area also covers parts of North Yorkshire (Thornton-in Craven, East and West Marton) and works with other local CCG's across those boundaries.

The building consists of consulting rooms, a large waiting area, disabled toilet and baby changing and breast feeding facilities. There is easy access into and throughout the building with automatic doors at the entrance of the building and a lift to the reception level; to facilitate easier access. There is a car park adjacent to the practice.

The practice has a patient list size of 8048 with a higher than national average of patients who are aged between 50 to 80 years. A high proportion of the over 80's live within their own homes and are supported with their medical needs by the practice.

The practice is open Monday to Friday 8 am to 6:30 pm. There are four female GPs and four male GPs (five of whom are partners). There is also a clinical pharmacist, two practice nurses (female), a health care assistant and phlebotomist (a clinical worker who takes blood samples).. The practice is supported by the practice manager and a team of administration and reception staff. Two of the reception staff are also phlebotomists.

The practice is also a GP training practice, providing support and guidance to trainee GPs.

General Medical Services (GMS) are provided under a contract with NHS England.

Updated 24 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at 21 April 2016. Overall the practice is rated as good for providing safe, effective, caring, responsive and well-led care for all of the population groups it serves.

Our key findings across all the areas we inspected were as follows:

• The practice was aware of and complied with the requirements of the duty of candour (being open and transparent with people who use the service, in relation to care and treatment provided). The partners encouraged a culture of openness and honesty, which was reflected in their approach to safety.

• All staff were encouraged and supported to record any incidents. There was evidence of good investigation, learning and sharing mechanisms in place.

• There was a clear leadership structure and a stable workforce in place. Staff were aware of their roles and responsibilities and told us the GPs and practice manager were accessible and supportive.

• Risks to patients were assessed and well managed. There were good governance arrangements and appropriate policies in place.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance.Staff had the skills, knowledge and experience to deliver effective care and treatment.

• Information regarding the services provided by the practice was available for patients.

• The practice had good facilities and was well equipped to treat and meet the needs of patients.

• There was a complaints policy and clear information available for patients who wished to make a complaint.

• Patients said they were treated with compassion, dignity and respect and were involved in care and decisions about their treatment.

• Patients were positive about access to the service. They said they found it easy to make both emergency and routine appointments.

• The practice sought patient views about how improvements could be made to the service, through the use of patient surveys, the NHS Friends and Family Test and their patient participation group (PPG).

We saw areas of outstanding practice:

• The team trained together for annual updates of safeguarding training and the training session were provided by the local safeguarding team using a ‘case study ‘ approach to enhance understanding and learning. In addition the practice completing safeguarding audits to identify where the practice could improve in the protection of vulnerable children and adults.
• Scheduled appointments for all patients were a minimum of 15 minutes in duration and longer appointments were available as required.
• The practice have developed a proactive approach to encourage patients with a learning disability to use their services. Information has been developed for patients to aid their understanding including use of plain English, large print and pictures. The named GP and health care assistant had proactively engaged with individuals to offer flexible and tailored appointments, explain the service, reassure and build up a relationship. This had resulted in all patients completing a health check with the practice and accessing additional services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 June 2016

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

• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met.

• 71 % patients diagnosed with asthma had received an asthma review in the last 12 months, compared to 75% nationally.

• 95% of patients diagnosed with chronic obstructive pulmonary disease (COPD) had received a review in the last 12 months, compared to 90% nationally.

• Longer appointments and home visits were available when needed.

Updated 24 June 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.

• Patients and staff told us children and young people were treated in an age-appropriate way and were recognised as individuals.

• Appointments were available outside of school hours and the premises were suitable for children and babies. All children who required an urgent appointment were seen on the same day as requested.

• The practice worked with health visitors to support the needs of this population group. For example the GP and practice nurse offered weekly baby clinic appointments which was at the same time as the drop in/ open access health visitor clinics to ensure mothers and babies can be seen effectively.

• Sexual health and contraceptive and cervical screening services were provided at the practice.

• 80% of women aged 25-64 had received cervical screening, compared to 80% both locally and nationally.

Updated 24 June 2016

• The practice provided proactive, responsive and personalised care to meet the needs of the older and vulnerable people in its population.Home visits and urgent appointments were available for those patients in need.

• The practice worked closely with other health and social care professionals, such as the health visitors, district nurses and local neighbourhood teams, to ensure vulnerable and housebound patients received the care and support they needed.

• Care plans were in place for those patients who were considered to have a high risk of an unplanned hospital admission.

• Health checks were offered for all patients over the age of 75 who had not seen a clinician in the previous 12 months.

Updated 24 June 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The needs of these patients 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 reflected the needs for this age group. For example, cervical screening, early detection of chronic obstructive pulmonary disease (a disease of the lungs) for patients aged 40 and above who were known to be smokers or ex-smokers.

• Appointments could be made on line, text reminders were available and access to patients on line records were facilitated.

Updated 24 June 2016

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

• The practice regularly worked with multidisciplinary teams in the case management of people in this population group, for example the local mental health team.

• The practice were proactive with the pre-screening in dementia and referrals to the memory assessment unit.

• One GP is vice chair of the Pendle Dementia Action Alliance and the practice was 'dementia friendly'. The staff had completed training in dementia, wore dementia friendly name badges and contacted patients by telephone to remind them of their appointments.

• 82% of patients diagnosed with dementia had received a face to face review of their care in the last 12 months, compared to the national average of 84%.

• 98% of patients who had a severe mental health problem had received an annual review in the past 12 months and had a comprehensive, agreed care plan documented in their record. This was significantly in excess of both the local and national average of 88%.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 24 June 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 and regularly worked with multidisciplinary teams in the case management of this population group.

• Longer appointments were given to those patients identified as needing them.

• The practice had identified a small number of vulnerable patients with complex needs, who were to be fast tracked for appointments and access to a clinician. All staff were aware of these patients.

• Staff knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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 liaised closely with social services for those children identified at risk and contributed toward child protection plans (this is a plan which identifies how health and social care professionals will help to keep a child safe).

• A palliative care register was available and used to provide a weekly update of patients for the weekly clinical meeting. The practice also met regularly with the Macmillan nurses and district nursing teams.

• One of the GPs was the cancer care lead and works at the local hospice providing all staff with links to this service and regular updates in cancer care.

• Regular health checks were in place for patients who had a learning disability. The patients were coded on the system, which enabled additional support to be provided as needed.

• Information was provided on how to access various local support groups and voluntary organisations.

• The practice had a proactive approach to encouraging patients with a learning disability to use their services. The GP and health care assistant has actively engaged with individuals to offer flexible and tailored appointments, explain the service, reassure and build up a relationship. This resulted in all patients completing a health check with the practice and accessing additional services.