Archived: North St Surgery Also known as Affinity Care

Updated 31 October 2016

North Street Medical Centre is a member of the Airedale Wharfedale and Craven Clinical Commissioning Group (CCG). Alternative Personal Medical Services (APMS) are provided under a contract with NHS England. They also offer a range of enhanced services, which include:

• Childhood vaccination and immunisations

• The provision of influenza and pneumococcal immunisations

• Facilitating timely diagnosis and support for patient with dementia

• Extended hours access

• Improving online access

North Street Medical Centre is located in in the northern aspect of Keighley, which is West Yorkshire town close to Bradford. The practice operates a branch surgery in nearby Vale Street. The majority of patients live within a mile of the surgery or branch. The practice is located in the 10% of most deprived localities in England.

The North Street practice at 151 North Street Keighley, BD21 3AU, is situated in converted old residential building. There are access facilities for people with disabilities, including a lift. There is a small car park facility on site with designated disabled bays. The Branch surgery at 8 Vale Street, Keighley BD21 4DA, is also located in a converted old house where patient facilities are all located on the ground floor and the main entrance has a sloped footpath enabling disabled access. There is street parking available.

The practice has a patient list size of 6700 which is made up of 98% Asian population (mainly Pakistani) 1% eastern European, and 1% white British, with an almost 50:50 ratio of male and female patients.

There are six GP’s who routinely worked at the practice (three male and three female). There were two advanced nurse practitioner (both female) and two nurses. There is a patient services manager and a team of administration and reception staff. Reception staff and clinical staff are able to speak several languages appropriate to the local population.

The practice is open between 8am to 6.30pm Monday and Friday, with extended to 7.30pm on Tuesday and Wednesdays. 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 provision of care for its patients. (The third sector includes a very diverse range of organisations including voluntary, community, tenants’ and residents’ groups.)

We were informed of the challenges the practice had undergone over recent years which were underpinned by the difficulty in recruitment of GP’s and a change in provider organisation of the practice on 1 December 2015.

Updated 31 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at North Street Medical Centre on 2 and 8 August 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 ethos and culture of the practice was to provide good quality service and care to patients.

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

• Patients’ needs were assessed and care was planned and delivered following best practice guidance.A

• The practice had good facilities and was well equipped to treat and meet the needs of patients. Information regarding the services provided by the practice and how to make a complaint was readily available for patients.

• The practice of, and 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.)

• The partners a culture of openness and honesty which was reflected in their approach to safety.

• Risks to patients were assessed and well managed.

• There were comprehensive safeguarding systems in place; particularly around vulnerable children and adults.

• 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

• There was a clear leadership structure.

• The practice partners were forward thinking, aware of future challenges to the practice and were open to innovative practice.

We saw one area of outstanding practice

As a result of data showing that the practice had high numbers of patients attending the Accident and Emergency (A & E) department at Airedale General Hospital for musculo-skeletal problems, such as back pain, the surgery introduced a self-referral physiotherapy clinic to its patients. As a result of this service the attendance of its patients to A & E for musclulo-skeletal problems had reduced by 74%. 

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 31 October 2016

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

• The GPs and advanced nurse practitioners (ANPs) had lead to check patients’ health care and treatment needs were being met.

• The practice maintained a register of patients who were a high risk of an unplanned hospital admission. Care plans and support was in place for these patients.

• The practice identified those patients who had complex needs and life limiting conditions and ensured they were on the palliative care register.

Updated 31 October 2016

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

• 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

• Patients 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.

• Immunisation rates were with the CCG and national rates for all standard childhood immunisations

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

• 73% of eligible patients had received cervical screening (CCG 79% and national average 77%).

• Appointments were available with both male and female GPs.

Updated 31 October 2016

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

• The practice provided proactive, responsive and person-centred care to meet the needs of the older people in its population.
• The practice worked closely with other health and social care professionals, such as the district nursing and local neighbourhood teams, to ensure housebound patients received the care and support they needed.
• The practice participated in Airedale Wharfedale and Craven Clinical Commissioning Group (CCG) initiatives to reduce the rate of acute admission to hospital.
• Patients who were considered to be at risk of frailty were identified and support offered as appropriate.
• Care plans were in place for those patients who were considered to have a high risk of an unplanned hospital admission and patients were reviewed as needed.
• Health checks were offered for all patients over the age of 75 who had not seen a clinician in the previous 12 months.
• Patients were signposted to other local services for access to additional support, particularly for those who were isolated or lonely.

Updated 31 October 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 provided extended hours appointments two evening per week, telephone consultations, online booking of appointments and ordering of prescriptions.
• The practice offered a range of health promotion and screening that reflected the needs for this age group.
• Health checks were offered to patients aged between 40 and 74 who had not seen a GP in the last three years.
• Students were offered public health recommended vaccinations prior to attending university.
• Travel health advice and vaccination were available.

Updated 31 October 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.
• Patients and/or their carer were given information on how to access various support groups and voluntary organisations.
• Staff had a good understanding of how to support patients with mental health needs or dementia.

Updated 31 October 2016

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 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 could evidence the number of children who were on a child protection plan (this is a plan which identifies how health and social care professionals will help to keep a child safe).

• Patients who had a learning disability received an annual review of their health needs and a care plan was put in place. Carers of these patients were also encouraged to attend, were offered a health review and signposted to other services as needed.

• We saw there was information available on how patients could access various local support groups and voluntary organisations.

• The practice had high numbers of non-English speaking patients who required translation services. The practice had translators on site every day and a number of clinical and administrative staff were multi-lingual.