Dr J Sullivan & Partners Also known as Moorside Surgery

Updated 2 February 2017

Dr J Sullivan & Partners’ practice is a member of the Bradford Districts Clinical Commissioning Group (CCG). Personal Medical Services (PMS) are provided under a contract with NHS England. They offer a range of enhanced services, which include:

• extended hours access
• improving patient online access
• delivering childhood, influenza and pneumococcal vaccinations
• facilitating timely diagnosis and support for people with dementia
• identification of patients with a learning disability and the offer of annual health checks
• identification of patients at a high risk of an unplanned admission and providing additional support as needed.

The practice is located in purpose built premises at 370 Dudley Hill Road, Bradford, BD2 3AA, which is situated on the northern outskirts of Bradford city centre. There are good disabled access and facilities onsite. There is car parking with three designated disabled spaces and a bicycle shed. There is an external pharmacy attached to the premises which can be accessed from the waiting area of the practice. There are an extensive number of consulting/clinic rooms. Access to the first floor of the building is via stairs or a lift.

The patient list size is currently 7,450. The ethnic origin of patients is approximately 80% white British and 20% from mixed ethnic backgrounds. The majority of patient demographics are comparable to CCG and national averages, with some variables. For example:

• 65% of patients have a long standing health condition (CCG 56%, national 54%)
• 57% of patients are in paid work or full-time education (CCG 60% and national 61%)
• 6% of patients are unemployed (CCG 7%, national 5%)
• The deprivation score overall is 31% (CCG 32%, national 22%)

There are seven GP partners (three male and four female) and a female salaried GP. Nursing staff consist of three practice nurses and two health care assistants; all of whom are female. The clinicians are supported by a business manager, an office manager and a team of administration staff who oversee the day to day running of the practice, some of whom also work on the reception desk. In addition there is a female pharmacist employed by the practice.

The practice is open Monday to Friday 7.30am to 6pm, with extended hours opening until 8pm on Monday and Wednesday. Appointments are available from 8.30am to 10.30am and 3pm to 5.30pm. Appointments can be pre-booked or made on the same day. Urgent care appointments and telephone consultations are also available outside of the usual appointment times. When the practice is closed out-of-hours services are provided by Local Care Direct, which can be accessed via the surgery telephone number or by calling the NHS 111 service.

The practice has good working relationships with local health, social and third sector services to support the provision of care for its patients. (The third sector includes a very diverse range of organisations including voluntary, community, tenants’ and residents’ groups.)

Dr J Sullivan & Partners is a teaching and training practice. They are accredited to train qualified doctors to become GPs (registrars) and to support undergraduate medical students with clinical practice and theory teaching sessions.

Updated 2 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr J Sullivan & Partners, known as Moorside Surgery, on 3 November 2016. Overall the practice is rated as good, with the provision of effective services being rated as outstanding.

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

• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients’ needs were assessed and care was planned and delivered following local and national care pathways and National Institute for Health and Care Excellence (NICE) guidance.
• Patient comments we received were overwhelmingly positive about the practice. The national patient survey had shown that patient scores for positive experiences were consistently higher than local and national averages. For example, 90% said they could easily get through to the practice by telephone (local 61%, national 73%) and 100% said they had confidence and trust in the last GP they saw or spoke to (local and national 95%).
• The practice staff had a good understanding of the needs of their practice population and were flexible in their service delivery to meet patient demands.
• The practice provided intensive support and interventions for those patients who had learning disabilities, complex mental health problems or were high users of NHS services. For example, some patients were given regular two weekly appointments to help maintain a stable lifestyle. Patients had direct access to regular support from a psychologist, psychiatrist or physiotherapist as needed, to prevent an inappropriate hospital admission.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice sought views on how improvements could be made to the service, through the use of patient surveys, the NHS Friends and Family Test and engagement with patients and their local community. For example, a children’s play area had been developed in conjunction with the patient participation group
• Risks to patients were assessed and well managed and there were effective safeguarding systems in place to protect patients and staff from abuse.
• The practice promoted a culture of openness and honesty. All staff were encouraged and supported to record any incidents using the electronic reporting system. There was evidence of good investigation, learning and sharing mechanisms in place.
• There was a clear leadership structure, staff were aware of their roles and responsibilities and told us the GPs were accessible and supportive.
• The practice complied with the requirements of the duty of candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment.)

We saw several areas of outstanding practice:

• The practice participated in the Bradford Health Hearts programme and could evidence that 100% of patients who had atrial fibrillation were being monitored for their anticoagulation (blood clotting) rates. This is essential for the safe management of this disease and the prevention of strokes. We saw evidence that the practice was the highest achieving in this area across Bradford and had received an award from the Clinical Commissioning Group (CCG) in recognition of their work.
• The practice facilitated many services to effectively manage and improve outcomes for patients. For example, newly diagnosed diabetic patients had access to the unique practice developed ‘getting started’ programme. Sessions were run with the practice nurse and a dietician to educate patients regarding dietary and lifetstyle choices to support positive self-management of their care. The practice had also participated in the Early Arthritis research project and they were one of three pilot sites in the CCG for Physio First (a self-referral direct access service to physiotherapy interventions). One of the GPs (who was on the advisory group for the National Institute for Health and Care Excellence) led a specialist headache management clinic which patients from other areas could also access.
• The practice worked within the local community and had facilitated a young people’s ‘eating for exams’ workshop and had also funded a drama group to work in the local secondary school focusing on healthy lifestyle awareness, such as bullying, sexual health, drug use and mental health. We saw evidence of very positive feedback received from participants with regard to these interventions.

However, there was an area of practice where the provider should make improvements:

• The practice should reassure themselves that all vaccines are transported to patients’ homes in accordance with the most recent public health guidelines.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 2 February 2017

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

• The practice nurses led on the management of long term conditions, supported by the GPs. Annual or six monthly reviews were undertaken to check patients’ health care and treatment needs were being met. There was an effective system for the follow-up of non-compliant patients.
• Longer appointments were available for this group of patients, and a ‘one stop’ approach was used with those who had multiple conditions; to reduce the need for several appointments.
• Home visits for these patients were undertaken by the practice nurses to support continuity of care and a holistic approach to their health and wellbeing.
• The practice participated in the Bradford Healthy Hearts programme and could evidence a proactive approach and a 100% anticoagulation rate for those patients who have atrial fibrillation (a type of arrhythmia, which means that the heart beats fast and irregularly). (Atrial fibrillation increases the risk of stroke and the use of anticoagulation medicines used to prevent blood clots can help to decrease that risk.)
• Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were consistently higher than local and national averages. The most recent published results showed the practice had achieved 100% (CCG and national averages 97%) of the total number of points available.
• QOF results also showed the practice was comparable to others for undertaking reviews of patients’ long term conditions. For example:

79% of patients diagnosed with asthma had received an asthma review in the last 12 months (CCG average 76%, national average 76%).

93% of patients diagnosed with chronic obstructive pulmonary disease (COPD) had received a review in the last 12 months (CCG average 91%, national average 90%).

92% of newly diagnosed diabetic patients had been referred to a structured education programme in the preceding 12 months (CCG average 90%, national average 92%).

• The practice facilitated many services to effectively manage and improve outcomes for patients, particularly those who had a long term condition. For example, newly diagnosed diabetic patients had access to the unique practice developed ‘getting started’ programme. Sessions were run with the nurse and a dietician to educate patients regarding dietary and lifestyle choices to support positive self-management of their care.

Updated 2 February 2017

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

• Appointments were available outside of school hours and the premises were suitable for children and babies. Same day access was available for all children who required medical attention.
• There was a dedicated play area to help parents keep their children occupied whilst waiting for their appointment.
• The practice worked with midwives, health visitors and school nurses to support the needs of this population group. For example, the provision of ante-natal, post-natal and child health surveillance clinics.
• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk.
• Childhood immunisations were offered in line with the public health immunisation programme. Uptake rates were generally higher than the CCG and national averages.
• Sexual health, contraceptive and cervical screening services were provided at the practice, which included coil fitting and implants.
• The practice promoted cancer screening programmes. For example, 87% of eligible patients had received cervical screening (CCG average 85%, national average 82%).
• The practice had facilitated a young people’s ‘eating for exams’ workshop and had also funded a drama group to work in the local secondary school focusing on healthy lifestyle awareness, such as bullying, sexual health, drug use and mental health. We saw evidence of very positive feedback from participants who attended these sessions.

Updated 2 February 2017

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

• Proactive, responsive care was provided to meet the needs of the older people in its population. The practice participated in the integrated care pilot in Bradford to support the care of elderly patients and avoid unplanned admissions.
• They offered rapid access appointments to those patients with enhanced needs and those who could not access the surgery due to ill health or frailty.
• Medication reviews were undertaken every six months or earlier if needed.
• The practice worked closely with other health and social care professionals, such as the district nursing team, to ensure housebound patients received the care and support they needed.
• Patients were signposted to other local services for additional support, particularly those who were isolated and lonely.
• GPs provided treatment and medication reviews to meet the needs of those patients who were registered in residential care settings.

Updated 2 February 2017

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 provided extended hours from 7.30am on weekdays, online booking of appointments, ordering of prescriptions and SMS text reminders.
• The practice offered a range of health promotion and screening that reflected the needs for this age group. For example, cardiovascular disease and diabetes prevention screening and advice. NHS health checks were offered to patients aged between 40 and 74 years who did not have a pre-existing condition.
• Nurse-led in-house smoking cessation clinics were available for patients.
• Travel health advice and vaccinations were available. The practice was a designated Yellow Fever Centre.

Updated 2 February 2017

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 crisis intervention team.
• Patients and/or their carer were given information on how to access various support groups and voluntary organisations.
• Patients who were at risk of developing dementia were screened and support provided as necessary.
• Annual health reviews were undertaken for people who had dementia or complex mental health conditions. For example, 86% of patients diagnosed with dementia had received a face to face review of their care in the preceding 12 months (CCG average 83%, national average 84%); 94% of patients who had a complex mental health problem, such as schizophrenia, bipolar affective disorder and other psychoses, had received a review of their care in the preceding 12 months (CCG 94%, national 89%).
• Staff could demonstrate a good understanding of how to support patients with dementia or mental health needs. Some staff had undertaken additional training such as Dementia Friends.
• The practice was one of three pilot sites for the primary care wellbeing service. Through this service, intensive support and interventions were provided for patients who had learning disabilities or complex mental health problems.

Updated 2 February 2017

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

• 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.
• Patients were signposted to other agencies for additional care and support as needed. We saw there were notices displayed in the patient waiting area informing patients how they could access various local support groups and voluntary organisations.
• The practice held a register of patients living in vulnerable circumstances including those who had a learning disability and patients who acted in the capacity of a carer.
• A 'flag' was used in the electronic patient record to alert clinicians to those carers who may be at risk of ‘carer stress’.
• Patients who had a learning disability were offered longer appointments and an annual health check. Care plans had been developed for patients to take home with them, they incorporated easy read language and the use of pictures to aid understanding. Patients were also referred to the Bradford Healthy Living Project. This was a self-advocacy group which was run for and by people who had a learning disability.