Archived: South Hiendley Surgery

Updated 10 December 2015

South Hiendley Surgery is located in a small detached building, approximately two miles from its main branch at Rycroft Primary Care Centre (PCC), Madeley Road, Havercroft, Wakefield WF4 2QG. It is part of the Wakefield Clinical Commissioning Group.

Personal Medical Services (PMS) are provided under a contract with NHS England. The practice is registered to provide the following regulated activities; maternity and midwifery services, family planning, surgical procedures, diagnostic and screening procedures and treatment of disease, disorder or injury. There is a small dispensary which has a team of two dispensers.

The practice is open between 8.30am to 11.30am Monday to Friday and 3.50pm to 6pm Monday, Tuesday and Friday. Patients can also access the main surgery at Rycroft PCC. Out-of-hours services are provided by Local Care Direct.

We were informed that South Hiendley Surgery and Rycroft PCC historically had a close working relationship with another practice, White Rose Surgery, Exchange Street, South Elmsall, Pontefract WF9 2RD. This had led to a merger of the practices in October 2010.

All three locations currently have separate registrations with CQC but share the same patient list, patient and QOF data, policies and procedures. (QOF is a voluntary incentive scheme for GP practices in the UK, which financially rewards practices for managing some of the most common long term conditions and implementing preventative measures.) We were informed that discussions were being held between the partners with regard to a possible demerger between Rycroft PCC and White Rose Surgery.

The total patient list size is 21821 patients. There is a higher than national average of patients who have a long standing health condition (64% compared to 54% nationally) or a health related problem which affects their daily life (61% compared to 49% nationally).

There are a range of clinical staff which rotate between South Hiendley Surgery and Rycroft PCC.  These consist of six GPs (4 male, 2 female), one male independent prescriber nurse manager, one female independent nurse prescriber, a  female practice nurse, a clinic nurse and a health care assistant. There is a practice manager, who had only been in post two weeks. They are supported by a team of reception and administration staff.

There is an accessible gym at Rycroft PCC, where a qualified gym instructor develops personalised fitness plans with each patient. Patients can self-refer or be referred by clinical staff. Patients also have access to secondary care specialist services, such as X-ray, urology, ophthalmology and audiology, which are consultant led and located in premises adjacent to the White Rose Surgery.

Updated 10 December 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at South Hiendley Surgery on 3 September 2015. Overall the practice is rated as good for providing safe, effective, responsive and well-led care for all of the population groups it serves.

We specifically found the practice to be outstanding for providing services to people with long term conditions.

Our key findings across all the areas we inspected were as follows:

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles.
• Staff understood and fulfilled their responsibilities to raise concerns and to report incidents, near misses and any identified safeguarding issues. There was a clear leadership structure and staff felt supported.
• Risks to patients were assessed and well managed.
• The practice had good facilities and was well equipped to treat and meet the needs of patients.
• Information about services and how to complain was available and easy to understand.
• Urgent appointments were available for patients the same day as requested, although not necessarily with a GP of their choice.
• Patients said they were treated with compassion, dignity and respect and were involved in care and decisions about their treatment.
• The practice sought patient views how improvements could be made to the service, through the use of patient surveys, the NHS Friend and Family test and the patient participation group (PPG).

We saw several areas of outstanding practice:

• The practice routinely screened for chronic obstructive pulmonary disease (COPD) in all patients who were smokers and aged 40 and above; irrespective of any apparent symptoms. This had resulted in a higher than average prevalence of COPD for the practice. As a result of these interventions the practice could evidence a 26% reduction in COPD related hospital admissions, in the previous 12 months.

• The practice had an in-house smoking cessation service which was facilitated by a trained member of staff. Through interventions and support offered they could evidence the number of quitters over the past 12 months. This had resulted in a 16% reduction of registered smokers.

• Staff provided kind, compassionate, caring and responsive services for patients above and beyond expectations. For example, delivering prescribed medicines to some patients who were housebound or found it difficult getting to the surgery. They also delivered food parcels to patients whose circumstances may make them vulnerable.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 December 2015

The practice is rated outstanding 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. Longer appointments and home visits were available when needed. Rapid access appointments were available for those with urgent needs. All patients had a named GP and a structured annual review to check their health and medication needs were being met. For those people with the most complex needs, the named clinician worked with relevant health and care professionals to deliver a multidisciplinary package of care.

The practice routinely screened for chronic obstructive pulmonary disease (COPD) in all patients who were smokers and aged 40 and above; irrespective of any apparent symptoms. Due to early intervention the practice could evidence a 26% reduction in the number of COPD related hospital admissions. All patients who had COPD, asthma, diabetes or epilepsy had individualised care plans in place.

The practice provided anticoagulation services for patients who were prescribed warfarin (a drug used in the prevention of the formation of blood clots in the blood vessels), and required regular blood tests. This service supported continuity of care and reduced the need for an unnecessary hospital attendance.

Updated 10 December 2015

The practice is rated 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. Appointments were available outside of school hours and the premises were suitable for children and babies. The practice told us all young children were prioritised and the under-fives were seen on the same day as requested. Staff told us children and young people were treated in an age-appropriate way and were recognised as individuals. The practice provided sexual health support and contraception, maternity services and childhood immunisations. Data showed immunisation uptake rates were comparable for the local area.

Updated 10 December 2015

The practice is rated good for the care of older people. The practice offered proactive, personalised care to meet the needs of older people in its population. Longer appointments, home visits and rapid access appointments were available for those patients with enhanced or urgent needs. The clinicians and medicine dispensing staff worked closely with other health and social care professionals, such as the district nursing team, to ensure housebound patients received the care they needed. Patients who were housebound, or found it difficult to collect their prescriptions, had their medicines delivered to their home by a member of staff.

Updated 10 December 2015

The practice is rated good for the care of working age people (including those recently retired and students). The needs of this population group had been identified and the practice had adjusted the services it offered to ensure these were accessible. The practice also offered online services, telephone triage/advice and a full range of health promotion and screening that reflected the needs of this age group.

Updated 10 December 2015

The practice is rated good for the care of people experiencing poor mental health (including people with dementia). All patients had a named GP. Annual health checks were offered for these patients and data showed 88% had received one in the last twelve months. The practice actively screened patients for dementia and maintained a register of those diagnosed. It carried out advance care planning for these patients.

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 who were experiencing poor mental health were given information on how to access various support groups and voluntary organisations, such as the Alzheimer’s Society and Age UK. Staff had received training on how to care for people with mental health needs. All the staff had been trained in dementia awareness. Patients were actively screened for dementia, which had resulted in an increase of prevalence in the practice. All patients had advance care planning in place.

Updated 10 December 2015

The practice is rated good for the care of people whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable circumstances, including those who had a learning disability. Longer appointments were available for patients as needed. Annual health checks were offered for those who had a learning disability and data showed 71% of these patients had received one in the last twelve months.

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 practice worked with multidisciplinary teams in the case management of this population group.

Staff delivered food bank packages to people whose circumstances may deem them vulnerable. They also delivered prescribed medicines to patients who found it difficult to access the practice during periods of ill health. Staff could identify if these patients’ physical or mental health had deteriorated and, therefore, ensured patients accessed support as necessary.

They informed patients how to access various support groups and voluntary organisations. There was an onsite drug and alcohol misuse worker to whom the clinicians could signpost/refer patients.