Willerby and Swanland Surgery

Updated 21 December 2016

Willerby and Swanland Surgery, 45 Main Street, Willerby, East Riding HU10 6BP, is located on the outskirts of Hull and is close to local bus routes. There is a small amount of car parking available including disabled parking. The practice is in a purpose built building with disabled access and consulting and treatment rooms on ground floor. There is one branch site, Swanland Surgery, The Old Pump House, West End, Swanland, East Riding HU14 3PE located in the village of Swanland which is approximately four miles from Willerby. There is disabled access and all consulting and treatment rooms are on the ground floor. This site was also visited during the inspection.

The practice provides services under a General Medical Services (GMS) contract with the NHS North Yorkshire and Humber Area Team. The registered practice population is approximately 8579, covering patients of all ages. The proportion of the practice population in the 65 years and over age groups is higher than the local CCG and England average and in the under 18 age group is similar to the local CCG and England average. The practice scores ten on the deprivation measurement scale, the deprivation scale goes from one to ten, with one being the most deprived. People living in more deprived areas tend to have a greater need for health services.

The practice has three GP partners and three salaried GPs, two full time and four part time. There are three male and three female GPs. There are three practice nurses and one phlebotomist (someone who takes blood), all part time and all female. There is a practice manager and a team of administrators, secretaries and receptionists and cleaners. The practice has undergone some change in the eight months prior to the inspection with the retirement of two GP Partners. Since the inspection the practice has recruited two more GPs to work at the practice.

The Willerby Surgery is open between 8am to 6pm Monday to Friday. Appointments are available from 8.30am to 11.30am and 1.30pm to 6.00pm Monday to Friday. Early morning pre-bookable appointments are available from 7.30am on a Tuesday, Wednesday and Thursday.

The Swanland surgery is open between 9am and 1pm and 2pm to 6pm on Monday, Wednesday and Thursday and from 9am to 1pm on Tuesday and 9am to 12pm on Friday. Appointments are available from 9am to 1pm Monday to Friday and 2pm to 6.00pm Monday, Wednesday and Thursday.

Information about the opening times is available on the website and in the practice leaflet.

The practice, along with all other practices in the East Riding of Yorkshire CCG area have a contractual agreement for the Out of Hours provider to provide OOHs services from 6.00pm. This has been agreed with the NHS England area team.

The practice has opted out of providing out of hours services (OOHs) for their patients. When the practice is closed patients use the 111 service to contact the OOHs provider. Information for patients requiring urgent medical attention out of hours is available in the waiting area, in the practice information leaflet and on the practice website.

The practice hosts medical students from the Hull York Medical School.

Updated 21 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Willerby and Swanland Surgery on 19 July 2016. We visited the main surgery in Willerby and the branch surgery at Swanland during the inspection. 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 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they were able to get same day appointments and pre bookable appointments were available.
• 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.

• The provider was aware of and complied with the requirements of the Duty of Candour.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Implement a process so that a written record is kept of references for new staff.

• Implement a process for the GPs to complete mandatory training at required intervals.

• Carry out fire drills at required frequencies.

• Undertake planned individual appraisal discussions with all staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 December 2016

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

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Nationally reported data for 2014/2015 showed that outcomes for patients with long term conditions were good. For example, the percentage of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months was 90% compared to the local CCG and England average of 88%.

• Longer appointments and home visits were available when needed.

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

Updated 21 December 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 or who failed to attend hospital appointments.

• Immunisation rates were comparable to the local CCG area for all standard childhood immunisations. For example, rates for all immunisations given to children aged 12 months, 24 months and five years in the practice ranged from 91% to 98% compared to 94% to 98% for the local CCG area.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• Nationally reported data from 2014/2015 showed the practice’s uptake for the cervical screening programme was 86% compared to the local CCG average of 85% and the England average of 82%.

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

• We saw good examples of joint working with midwives, health visitors and school nurses.

  The practice monitored any non-attendance of babies and children at vaccination clinics and worked with the health visiting service to follow up any concerns.

Updated 21 December 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. Patients over the age of 75 had a named GP.

• The practice had assessed the older patients most at risk of unplanned admissions and had developed care plans.

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

• Nationally reported data for 2014/2015 showed that outcomes were good for conditions commonly found in older people. For example, performance for heart failure indicators was 100%; this was 1.9% above the local CCG average and 2.1% above the England average.

• The practice was participating in the EASYcare Project. The practice would work with social care staff to undertake a needs based assessment of all the practice patients over 75 years of age, those living in care homes and learning disability units. This would identify a summary of the patient’s needs, allowing them to be signposted to appropriate local resources. The information would then be used by the practice to inform patients care plans. It would also help to shape future services in the town.

Updated 21 December 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.

• Telephone consultations were available every day with a call back appointment arranged at a time to suit the patient, for example during their lunch break.

• Early morning appointments were available during the week.

• The practice referred and sign posted people who needed support for alcohol or drug problems to local counselling services.

Updated 21 December 2016

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

• Nationally reported data from 2014/2015 showed 95% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the preceding 12 months. This was above the local CCG and England average of 84%.

• Nationally reported data from 2014/2015 showed the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive care plan documented in their record in the preceding 12 months was 100%. This was above the local CCG average of 91% and the England average of 88%.

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

• The practice carried out advanced care planning for patients with dementia. Staff had completed dementia friends training (a dementia friend is someone who learns more about what it is like to live with dementia and turns that understanding into action).

• 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.

Updated 21 December 2016

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

• The practice held registers of patients living in vulnerable circumstances which included those with a learning disability.

• The practice offered longer appointments for people with a learning disability.

• Nursing staff used easy read leaflets to assist patients with learning disabilities to understand their treatment.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• The practice told 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.

• Staff had completed training in the identification of potential exploitation and female genital mutilation.

• Telephone interpretation services were available and information leaflets in different languages were provided when required.