Homestead Medical Centre

Updated 7 October 2016

The practice surgery is located on Homestead Drive in Wakefield, West Yorkshire WF2 9PE. The practice serves a patient population of around 6,400 and is a member of NHS Wakefield Clinical Commissioning Group.

The surgery is located in purpose built premises and is readily accessible for those with a disability, for example the main door is served by a ramp from the car park and a hearing loop had been installed for those with a hearing impairment. There is parking available on site for patients and an independent pharmacy is attached to the practice.

The practice age profile shows that 26% of its patients are aged under 18 years (compared to the CCG average of 20% and the England average of 21%), whilst it is below both the CCG and England averages for those over 65 years old (12% compared to the CCG average of 18% and England average of 17%). Average life expectancy for the practice population is 78 years for males and 81 years for females (CCG average is 77 years and 81 years and the England average is 79 years and 83 years respectively). The practice population has a slightly higher than average number of patients with a long standing health condition at 59% compared to the CCG average of 58% and the national average of 54%. The practice serves some areas of higher than average deprivation and is ranked in one of the third most deprived areas in the country. The practice population is primarily composed of British/Mixed British patients, although there are significant numbers of patients who are from Pakistani/British Pakistani, Eastern European and African backgrounds.

The practice provides services under the terms of the Personal Medical Services (PMS) contract. In addition the practice offers a range of enhanced local services including those in relation to:

• Childhood vaccination and immunisation

• Influenza and Pneumococcal immunisation

• Rotavirus and Shingles immunisation

• Dementia support

• Risk profiling and case management

• Support to reduce unplanned admissions.

• Minor surgery

• Learning disability support

• Improving patient online access

• Patient participation

As well as these enhanced services the practice also offers additional services such as those supporting long term conditions management including asthma, chronic obstructive pulmonary disease, diabetes, heart disease and also offers healthy lifestyle advice to support wider community health and wellbeing.

Attached to the practice (or closely working with the practice) is a team of community health professionals that includes health visitors, midwives, members of the district nursing team and health trainers.

The practice has three GP partners (one male, two female) and utilises GP locum support when required. In addition the clinical team also comprises of one advanced nurse practitioner, two practice nurses and two health care assistants (all female). Clinical staff are supported by a practice manager and an administration and reception team.

The practice appointments include:

• Pre-bookable appointments

• On the day/urgent appointments

• Telephone triage/consultations where patients could speak to a GP or advanced nurse practitioner.

Appointments can be made in person, via telephone or online.

The practice is open between 8am and 6.30pm Monday to Friday. The practice also offers early appointments from 7am to 8am on Tuesdays and Thursdays. Additionally the practice works with other local GPs to offer appointments from 6.30pm to 8pm Monday to Friday and from 9am to 3pm on a Saturday; these are available at a nearby practice.

The practice is accredited as a training practice and supports GP registrars for six monthly periods.

Out of hours care is provided by Local Care Direct Limited and is accessed via the practice telephone number or patients can contact NHS 111.

Updated 7 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Homestead Medical Centre on 9 August 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.
• Risks to patients were assessed and well managed.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a GP and there was continuity of care, with urgent appointments available the same day.
• 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.

  
  

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 October 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. At the time of inspection 1,105 patients were on the practice long term condition management register.

• Patients were offered annual reviews based on their birthday month although if required reviews could be carried out on a more regular basis.

• Patients with long term conditions were offered longer appointments and were screened for depression during contact with the practice.

• Performance for diabetes related indicators was above the local and national averages. For example, 93% of patients on the diabetes register had a record of a foot examination and risk classification being carried out in the previous 12 months compared to the CCG average of 89% and the national average of 88%
• 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.

Updated 7 October 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.

• We were told that children and young people were treated in an age-appropriate way and were recognised as individuals. The practice was also working toward achieving “Young Person Friendly” accreditation to better serve the needs of young patients.

• A young person’s leaflet had recently been developed which gave key practice information as well as details of local support services such as those dealing with contraception/sexual health and mental health issues as well as some seldom considered issues such as young person’s bereavement support. These leaflets were available in the waiting room and were also distributed to young patients directly by clinicians.

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

• There was a dedicated clinic for six to eight week baby and mum checks. Non-attenders were followed up by the practice and the health visitors were informed that the appointment at the clinic had been missed.

• Midwife-led ante-natal clinics were hosted by the practice on a weekly basis.

Updated 7 October 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.

• All patients aged over 65 years were contacted annually for flu immunisation. The invitation was made via letter and non-responders were followed up with a telephone call to encourage attendance. Flu sessions were organised to maximise uptake and were held at various times, which included Saturday mornings.

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

• The practice delivered an avoiding unplanned admissions service which provided proactive care management for patients who had complex needs and were at risk of an unplanned hospital admission. At the time of inspection the practice had 105 patients on their avoiding unplanned admissions register.

• All patients aged over 75 years were offered an annual health check.

• The waiting room provided raised high back chairs which were suitable for the elderly and those with mobility problems.

Updated 7 October 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. For example, the practice offered 7am to 8am appointments twice a week and telephone triage/consultations were available for patients who could not get to the practice for a regular appointment.

• The practice was proactive in offering online services such as booking and cancellation of appointments and ordering repeat prescriptions.

• The practice offered a full range of health promotion and screening that reflected the needs for this age group, such as cervical screening and NHS health checks.

Updated 7 October 2016

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

• Performance for mental health related indicators was above the local and national averages. For example, 95% of patients diagnosed with dementia had had their care reviewed at a face-to-face meeting in the previous 12 months compared to CCG and national averages of 84%

• The practice regularly worked with multidisciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• 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.

Updated 7 October 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 including those with a learning disability, the frail elderly with complex care needs and those coming to the end of life.

• The practice offered longer appointments and health checks for patients with a learning disability.

• The practice was registered under the Wakefield Safer Places Scheme. This voluntary scheme seeks to assist vulnerable people to feel safer when travelling independently. Registered sites have agreed to offer support to the individual and would contact a named relative, carer or friend if the person was in distress.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed 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.

• The practice had made a number of changes to better meet the needs of patients with a physical disability or sensory impairment. These included the provision of more appropriate seating and improvements to signage.