The Family Doctors Also known as Dr C A Clyde

Updated 17 March 2016

The Family Doctors is situated in Whitkirk about four miles east of Leeds and is part of the Leeds South and East Clinical Commissioning Group (CCG). The practice is located in a small building which is leased. There is a small reception and waiting area which has a low rise reception counter. It is open plan and some conversations could be overheard, although there is a separate room available should it be needed. We were informed of the plans for the modernisation and redesign of the premises, which were due to be completed before the end of March 2016.

The practice is located in one of the lesser deprived areas of Leeds. It has a patient list size of 2,250 with a higher than national average of patients who are over the age of 50. Sixty four per cent of patients have a long standing health condition, compared to 54% nationally. There is a lower than average unemployment rate of 1%, compared to 6% nationally. Ninety nine percent of patients are white British.

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

The practice is open Monday to Friday 8am to 12.30pm and 2pm to 6.30pm, with the exception of Thursday when it is closed from 12 midday. Saturday morning appointments are available from November 2015 to March 2016 under the Winter Pressure Scheme. 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.

There is one female GP, who is supported by two regular male locum GPs. The practice is also staffed by one female practice nurse, a female health care assistant, a practice manager, an administrator and a team of experienced administration and reception staff.

General Medical Services (GMS) are provided under a contract with NHS England. The Family Doctors is registered to provide the following regulated activities; maternity and midwifery services, diagnostic and screening procedures and treatment of disease, disorder or injury. They also offer a range of enhanced services such as influenza, pneumococcal and childhood immunisations.

Updated 17 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Family Doctors on 26 January 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:

• There was an open and transparent approach to safety and an effective system was in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• 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.
• 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 an appointment, there was continuity of care and urgent appointments were available on the same day as requested.
• The practice had good facilities and was well equipped to treat and meet the needs of patients.
• The practice sought patient views how improvements could be made to the service, through the use of patient surveys, the NHS Friends and Family Test and the patient reference group.
• Information about services and how to complain was available and easy to understand.
• There was a clear leadership structure and staff were supported by management.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw areas of outstanding practice:

• The practice had good links with the local community. They had undertaken a coffee morning to focus on raising awareness of dementia and actively engaged with local groups in providing additional support for patients.
• The GP and nursing staff did ‘pop in’ home visits for patients who they may have had concerns about or were vulnerable, to ensure they were safe and receiving the care and support they needed.

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

• Maintain a record of all portable appliances which require testing and/or calibration to ensure all equipment is tested in line with health and safety guidance.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 17 March 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. The practice nurses had lead roles in long term conditions management and patients at risk of hospital admission were identified as a priority.
• Longer appointments and home visits were available when needed.
• The practice delivered care for patients who had diabetes or chronic obstructive pulmonary disease (a disease of the lungs) using an approach called The House of Care model. This approach enabled patients to have a more active part in determining their own care and support needs in partnership with clinicians.

• 100% of newly diagnosed diabetic patients had been referred to a structured education programme in the last 12 months, compared to 87% locally and 90% nationally.
• 81% of patients diagnosed with asthma had received an asthma review in the the last 12 months, compared to 75% locally and nationally.
• Patients who required palliative care were provided with support and care as needed; in conjunction with other health care professionals.

Updated 17 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.
• 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 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.
• Immunisation uptake rates were high for all standard childhood immunisations, achieving 100% for many vaccinations.
• Sexual health and contraceptive and cervical screening services were provided at the practice.
• 88% of eligible patients had received cervical screening, compared to 82% both locally and nationally.

Updated 17 March 2016

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

• The practice provided proactive, responsive and personalised care to meet the needs of the older people in its population. Home visits and urgent appointments were available for those patients with enhanced needs.
• The practice worked closely with other health and social care professionals, such as the district nursing team, to ensure housebound patients received the care 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.
• The practice could identify those patients who were most at need of care and support.

Updated 17 March 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.
• Saturday morning clinics were offered during the Winter Pressure Scheme from November 2015 until the end of March 2016.
• 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 cardio-vascular disease for patients aged 40 and above, and health checks for patients between the ages of 16 and 75 who had not seen a GP in the last three years.
• Meningitis and measles mumps and rubella (MMR) vaccinations were offered to students prior to them commencing university. There were temporary registration facilities for students who lived away during university terms.
• The practice offered a travel vaccination clinic.

Updated 17 March 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, such as the local mental health team, in the case management of people in this population group. Patients and/or their carer were given information on how to access various support groups and voluntary organisations, such as Carers Leeds.
• 87% of patients diagnosed with dementia had received a face to face review of their care in the last 12 months, which was comparable to the local and national averages
• All 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 higher than both the local and national average of 88%.
• The practice had good links with the local community. They had undertaken a coffee morning to focus on raising awareness of dementia and actively engaged with local groups in providing additional support for patients.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 17 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 and regularly worked with multidisciplinary teams in the case management of this population group.
• Information was provided on how to access various local support groups and voluntary organisations.
• Longer appointments were available for patients as needed.
• 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 GP and nursing staff did ‘pop in’ home visits for patients who they may have had concerns about or were vulnerable.