Dr DO Yates' Practice

Updated 17 August 2016

Dr DO Yates’ Practice is registered with the Care Quality Commission (CQC) as a partnership provider in Cheadle, North Staffordshire. The practice holds a General Medical Services (GMS) contract with NHS England. A GMS contract is a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract.

The practice area is one of low deprivation when compared with the national and local Clinical Commissioning Group (CCG) area. At the time of our inspection the practice had 7521 patients. The practice age distribution is comparable with the national and CCG area except there is a greater percentage of patients aged 65 – 69 (22%) when compared to the national average (17%). The percentage of patients with a long-standing health condition is 51% which is comparable with the local CCG and national averages.

Dr DO Yates’ Practice provides services from two separate sites and patients can attend either of these. Well Street Medical Centre is the main practice. The practice offers a dispensing service to eligible patients from a dispensary at the main site. To improve access to medicines in a rural area, dispensed prescriptions are taken to the branch site twice a week for collection whilst a dispenser is present. The main practice is open between 8am and 6pm Monday to Friday. It is closed Thursday afternoons but provides extended opening hours 7.30am to 8am and 6pm until 8pm on Wednesdays. GP open access appointments are available Monday to Friday 8am to 9.30am. Pre-bookable appointments are available 11.30am to 1pm every week day morning and 2.30pm to 6pm each weekday excluding Thursdays. Patients can book appointments up to five weeks in advance. The practice does not routinely provide an out-of-hours service to their own patients but patients are directed to the out of hours service, Staffordshire Doctors Urgent Care when the practice is closed.

The branch practice is at Ipstones Memorial Hall. This provides open access appointments on Tuesdays and Fridays between 11.30am to 12.30pm. The dispensing service is available during this time.

The practice staffing comprises of:

• Two male GP partners

• Three female salaried GPs

• A GP Registrar

• Three female practice nurses

• A female health care assistant

• A practice manager

• An assistant practice manager

• A team of 10 administrative staff working a range of hours.

• Two dispensary staff

The practice provides a number of specialist clinics and services. For example long term condition management including asthma, diabetes and high blood pressure. It also offers services for family planning, childhood immunisations, travel vaccinations and phlebotomy (the taking of blood from a vein for diagnostic purposes). The practice is a training practice for GP registrars and doctors who are undertaking the two year, general postgraduate medical training programme to gain knowledge, experience and higher qualifications in general practice and family medicine.

Updated 17 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr DO Yates' Practice on 15 July 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 been trained to provide them with 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 on the practice’s website. Improvements were made to the quality of care as a result of complaints and concerns.
• Open access and urgent appointments were available Monday to Friday and patients could pre-book appointments five weeks in advance. Some patients said they found it difficult to make an appointment with a named GP and could wait up to three weeks to see their GP of choice.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by the 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.

The areas where the provider should make improvements are:

• Ensure appropriate contact details are included in the policy for safeguarding vulnerable adults for staff to refer to.

• Formally audit the three monthly infection control information gathered to identify trends and ensure monitoring and improvement.

• Ensure that the practice’s repeat prescription and medication review protocol is fully adhered to and implement a system to track prescriptions through the practice.

• Implement a robust system to check that oxygen cylinders are in date and fit for purpose in the event of a medical emergency.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 August 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 five Quality and Outcomes Framework (QOF) indicators for care of patients with diabetes were comparable with other practices. For example, the percentage of patients with diabetes, on the register, who have had influenza immunisation was 100% compared with the national average of 95%.

• Longer appointments and home visits were available when needed.

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

Updated 17 August 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 A&E attendances. Immunisation rates were 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.

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

• Same day appointments were available for children.

Updated 17 August 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.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• The practice had identified the 4% most vulnerable of patients registered with the practice which included patients over 90 years old and the frail elderly. The care plan co-ordinator had visited this group of patients in their home or in the practice to carry out an initial assessment and care plans were put in place to help to meet patients’ social and health needs.

Updated 17 August 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 reflected the needs for this age group.

• The practice’s uptake for the cervical screening programme was 81%, which was comparable to the national average of 82%. The practice’s exception reporting was 2.6% which was lower than the Clinical Commissioning Group (CCG) rate of 5% and the national rate of 6% meaning more patients were included.

• The practice encouraged its patients to attend national screening programmes for bowel and breast cancer screening. Screening for bowel cancer was above the CCG and national averages.

• The practice offered extended opening hours for working aged people between 7.30am and 8am and 6pm and 8pm on Wednesdays.

Updated 17 August 2016

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

• Eighty per cent of patients with a recognised mental health condition had a comprehensive, agreed care plan documented in their record, in the preceding 12 months. This was comparable with the CCG average of 87% and the national average of 88%. There was also a lower than average exception reporting rate of 5% compared with the CCG average of 12% and the national average of 13% meaning a higher than average rate of patients had been included.

• Eighty-five per cent of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the CCG and national averages of 84%. The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice 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 patients with mental health needs and dementia.

• The practice hosted twice weekly community psychiatric nurse sessions for patients experiencing poor mental health.

Updated 17 August 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 children with a child protection plan and those with a learning disability.

• Same day appointments were available for those patients living in a local women’s refuge.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff 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 was in the process of establishing a monthly tea party for a small group of vulnerable and frail patients to combat loneliness & social isolation. With the support of the patient participation group patient volunteers were being sought to bake and/or provide lifts to this vulnerable group of patients.

• To improve access to GP services in a rural area, the practice provided a branch practice twice weekly in a nearby village and dispensed medicines were also taken there for collection.

• The practice held six weekly palliative care meetings to review and monitor the care of patients nearing the end of their lives.