Royds Healthy Living Centre

Updated 19 September 2016

The Royds Healthy Living Centre provides services for approximately 24,500 patients. The surgery is situated within the Bradford District Clinical Commissioning group and is registered with the Care Quality Commission (CQC) to provide primary medical services under the terms of a personal medical services (PMS) contract. This is a contract between general practices and NHS England for delivering services to the local community.

The Royds Healthy Living Centre is registered to provide diagnostic and screening procedures, treatment of disease, disorder or injury and maternity and midwifery services. They offer a range of enhanced services such as childhood immunisations, facilitating timely diagnosis and support for people with dementia and enhanced services for those with a learning disability.

The Royds Healthy Living Centre is located at :-

Royds Healthy Living Centre

20 Ridings Way

Off the Crescent

Bradford

BD6 3UD

The other three locations that we also inspected on the day have clinical staff and two receptionists who are on rota at that site on any particular day. Patients can be seen at any of the practice sites.

These locations are:

Ridge Medical Centre

Cousen Road

Great Horton

Bradford

BD7 3JX

93 Smith Avenue

Wibsey

Bradford

BD6 1HA

Westbourne Green Community Health Centre

50 Heaton Road

Manningham

Bradford

BD8 8RA

There is a higher than average number of patients under the age of 39, in common with the characteristics of the Bradford District area. There are fewer patients aged over 40 than the national average. The National General Practice Profile states that 59% of the practice population is from an Asian background with a further 7% of the population originating from black, mixed or non-white ethnic groups.

The practice is a partnership of 20 GPs who work full time (11 partners and nine salaried). The practice is staffed by advanced nurse practitioners, practice nurses, Mental Health Nurses, Epilepsy Nurses and health care assistants (HCA’s). The clinical team are supported by a business manager and a team of 100 administrative staff. The practice also has patient ‘Practice Health Champions’.

The practice catchment area is classed as being within one of the 10% most deprived areas in England. People living in more deprived areas tend to have a greater need for health services.

Normal Operating Times 8am to 6:30pm Monday to Friday.

Consulting times for booked appointments: 8:30am to 11:30am and 3:30pm to 6pm.

Extended Hours - Tuesday: 7am to 8am,

Same Day Assessment Clinic - Monday to Friday: 8:30am to 12:30pm and 2pm to 6pm

Great Horton surgery is closed on Saturdays and Sundays.

Great Horton surgery is closed every Friday lunchtime between 12pm and 2pm and on the fourth Friday of every month from 12pm for the whole afternoon for staff training and GP Education.

If patients require urgent advice or a home visit out of hours, a central number will transfer them directly to the Out of Hours service.

Updated 19 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Royds Healthy Living Centre on 19 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.

• 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 and easy to understand. The GPs and Business Manager had met with patients to discuss their concerns and improvements were made to the quality of care as a result of complaints and concerns. There were two lead GPs identified who led on all clinical complaints and provided advice and support to other clinicians in the practice in relation to complaints.

• Risks to patients were assessed and well managed and the practice was able to evidence references for all staff with copies of job descriptions. The practice had a robust electronic storage and retrieval system in place for staff records. All staff had appropriate Disclosure and Barring Service check (DBS) which had been undertaken on all staff. DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable.

• 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 management. The practice proactively sought feedback from staff and patients, which it acted on. Staff told us that they would feel confident to raise any concerns with the GP partners and that there was an open and supportive culture within the practice.

• The provider was aware of and complied with the requirements of the duty of candour.

We saw areas of outstanding practice

• Royds Healthy Living Centre actively looked to make sure that they identify and prioritise care for any who may be vulnerable. The practice has pioneered a new template with the CCG in the last year around equitable access needs and they have already met the new standard well in advance of the CCG deadline.

• In the role as mental health commissioning lead for the CCG a Royds Healthy Living Centre GP led the team that designed and established the award winning First Response Service. All patients on the SMI (Severe Mental Illness) register are given an annual check-up focusing on the five care processes defined nationally.

• The practice health champions group hosted a number of community focussed social groups such as the” Knit and Natter” group. The practice and the partners used these groups to deliver health education messages and improve access to health care for their patients. For example, the practice focussed on teaching people how to book and arrange appointments and what services were available.

• The practice health champions managed stalls and provision of second hand clothes. There were stalls in reception that encouraged all to participate in supporting this good cause.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 September 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 for example diabetes and patients at risk of hospital admission were identified as a priority.
• Outcomes for patients with diabetes were comparable to national averages. For example, 99% of patients on the diabetes register had an influenza immunisation in the preceding 12 months, national average 94%.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and 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.
• The practice emphasises prevention, for example a spirometry pilot in chronic smokers was undertaken which identified and reduced the number of smokers.
• The practice has a large team of Practice Nurses with a range of LTC qualifications and experience who can provide support and care to this patient group.
• The practice has recently been involved in a local incentive scheme “Bradford Breathing Better” targeting the severe asthmatic patients, and also run their own spirometry pilot in chronic smokers to try and prevent the onset of COPD.
• The practice is a Training Centre for Practitioner with a Special Interest (PWSI) courses delivering diplomas in cardiology, diabetes, women’s health and MSK (Musculoskeletal disorders) in association with the University of Bradford.

Updated 19 September 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. For example, when children did not attend for GP or hospital appointments, the practice would ensure that reports were run to check for any patterns occurring or any safeguarding concerns.
• Immunisation rates were consistently high for all standard childhood immunisations. For example MMR (measles, mumps and rubella) practice was 98% and CCG and national average was 95%.
• The number of women that had attended for cervical screening in the preceding five years was 76% compared to the CCG average of 81% and national average of 82%.
• The practice held baby clinics supported by GPs and health visitors and had systems in place to ensure that all babies attended their appointments in line with the immunisation programme.
• Children were accommodated where possible in evening surgeries to reduce non-attendance at school.
• Children with severe and long term disabilities were prioritised for appointments regardless of their age.
• Health Education England made a film at the practice about ‘Spotting the signs of child sexual exploitation’ which has received over 11,500 views on You Tube. (Link - https://www.youtube.com/watch?v=sC4Nn_mYKu0)
• The practice ensure all patients aged under one are guaranteed a same day appointment.
• 54 children are currently subject to Child Protection Plan at the practice.
• All children under 10 years are accommodated in the Same Day Assessment Clinic.

Updated 19 September 2016

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

• The practice supported relatively small numbers of older people and offered proactive, personalised care to meet their needs.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• Monthly meetings were attended by the district nursing team. The needs of older people, housebound and palliative care patients were also reviewed at quarterly multidisciplinary meetings.
• The practice worked closely with the community pharmacist who visited older people at home to conduct medication reviews and check compliance.
• The practice offered same day access for over 80s including home visits.
• The group of practices was identified as the pilot practice as part of the oral nutritional support project funded by Bradford CCG's. Following an audit of patients prescribed oral nutritional supplements (ONS), some patients were identified as needing a review. In care homes 31 patients were reviewed jointly with the project dietician and community matrons from the practice. Out of the 31 patients, 18 patients had their prescribed ONS stopped, four remained the same, nine patients prescription for ONS changed. This resulted in an annual saving of £13,388, £432 saving per patient.
• In addition to an annual review all patients over 75 are guaranteed care the same day either by an appointment or by a phone call from the clinical team.
• The practice has been involved in an “End of Life” project locally with the CCG looking at implementing gold standard care for these patients.
• Thepractice runs a Dementia Clinic and is Dementia friendly, working closely with Carer organisations to provide support to both patients and their carers.

Updated 19 September 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 reflects the needs for this age group.
• The practice offered an extended hours service on a Tuesday morning from 7am when patients could be seen by a GP or an advanced nurse practitioner.
• The practice offered telephone consultations to patients who were unable to attend the surgery in person due to work commitments.

Updated 19 September 2016

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

• Data showed that 75% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is below than the national average.
• The percentage of patients with schizophrenia, bipolar disorder and other psychoses whose alcohol consumption was recorded in the previous 12 months was 93%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice was opportunistically screening patients for dementia.
• The practice was participating in a CCG led initiative to offer physical health checks to patients with serious mental illness. A range of services including smoking cessation, ECGs and weight management advice was available to these and other patients.
• The practice carried out advance care planning for patients with dementia. These would be discussed with family and carers where appropriate.
• 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 and staff had undertaken dementia awareness training.
• A practice GP was involved in designing and establishing the award winning First Response service. All patients on the SMI (Severe Mental Illness) register are given an annual check-up focusing on the five care processes defined nationally.

Updated 19 September 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 reflects the needs for this age group.
• The practice offered an extended hours service on a Tuesday until 8pm when patients could be seen by a GP or an advanced nurse practitioner.
• The practice offered telephone consultations to patients who were unable to attend the surgery in person due to work commitments.