College Lane Surgery

Updated 25 May 2016

College Lane Surgery is located on Barnsley Road, Ackworth, Pontefract, the practice also operates the Thorpe Lane branch surgery which is located on Thorpe Lane in nearby Thorpe Audlin. Both main and branch surgeries currently provide services for around 9,100 patients. The main surgery in Ackworth is situated in a purpose built unit and is of modern design with parking available on site. The main surgery building can be accessed by those with a disability via a ramp and doorways are wide enough to accomodate disability scooters and pushchairs. The branch surgery in Thorpe Audlin is located in a small purpose built unit and it is also accessible to those with a disability. The practice is a member of the NHS Wakefield Clinical Commissioning Group (CCG.)

The practice population age profile shows that it is slightly above the England average for those over 65 years old (21% of the practice population is aged over 65 as compared to a CCG average of 18% and an England average of 17%), additionally 54% of the practice population report having a long standing health condition compared to a CCG average of 58% and an England average of 54%. Average life expectancy for the practice population is 81 years for males and 85 years for females (CCG average is 77 years and 81 years respectively and the England average is 79 years and 83 years respectively). In general older people and those with a long standing health issue tend to have a greater need for health services.

The practice provides services under the terms of the Personal Medical Services (PMS) contract . At the time of inspection the practice was in the process of registering with the CQC to provide surgical procedures as this service was being offered to patients without the necessary registration process having been completed. In addition to this 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

• Extended hours

• Learning disability support

• Minor surgery

• Patient participation

• Unplanned admissions

As well as these enhanced services the practice also offers or hosts additional services including:

• Chronic illness management including asthma, angina and diabetes.

• A practice nurse run parent/carer-free clinic for which an appointment is not necessary.

• Travel vaccination services.

• Non-NHS services including medicals for pre-employment, sports and driving requirements, insurance claim forms and private sick notes.

• Community midwives hold weekly clinics in the surgery, and patients can access and receive support from district nurses, physiotherapists, podiatrists and health trainers.

The Thorpe Audlin branch surgery offers a more limited range of services which necessitates patients traveling to the main practice to receive some treatments and services such as minor surgery.

The practice has four GP partners (two male, two female), three salaried GPs (male), there is also currently one GP Registrar and one Foundation Year 2 Doctor gaining training and experience within the practice. In addition there is a nursing team of one nurse prescriber (female), one practice nurse (female) and two health care assistants (both female). Clinical staff are supported by a practice manager and an administration/reception team.

The practice has an active role in the training and development of health professionals, activities carried out by the practice include:

• Acting as an approved training practice for GP Registrars, two of the practice GPs are approved GP Trainers.

• Coordinating undergraduate nursing student placements for surgeries in the Wakefield area as the Wakefield Primary Care First HUB.

• Coordinating the Apprentice Health Care Assistants scheme in partnership with Barnsley College.

The practice offers a range of appointments, these include:

• Pre-bookable appointments with a GP or nurse.
• Telephone appointments.
• On the day appointments released daily at 8am and urgent on the day appointments as required.

Appointments could be made in person, via the telephone or on- line.

The main College Lane Surgery is open Monday to Friday 8am to 6.30pm. An early surgery is available alternate Tuesdays 7am to 8am and a morning surgery also operates on alternate Saturdays 8am to 11.30am.

The branch surgery at Thorpe Audlin is open 9am to 11am on a Tuesday and a Friday.

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

Updated 25 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at College Lane Surgery, Ackworth, Pontefract and the practice branch surgery at Thorpe Audlin on 19 February 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.
• The practice had developed services which met specific local need.
• 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.
• Patients said they generally found it easy to make an appointment with a named GP and that 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.

We saw areas of outstanding practice:

• The practice had established a weekly teenage health clinic. This offered a confidential, parent/carer free service for young people and was held in a separate area away from other patients. In the past 12 months 65 young people had attended these clinics for health advice and treatment. The practice had in place processes with regard to ensuring safeguarding controls and Fraser and Gillick competences were met.
• The practice had a proactice approach to services for patients with dementia and their families. For example the practice had:
  • It had instituted a wide ranging dementia screening programme and offered effective support to those subsequently diagnosed with a cognitive impairment.
  • Worked hard to raise community awareness of dementia and staff were aware of the needs of this group of people and organisational and physical adjustments and improvements had been put in place to meet their needs.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 May 2016

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

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

• Clinical staff worked together and carried out multi-condition reviews whenever possible rather than inviting the patient to take part in a number of individual reviews.

• 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.

• Care plans were in place for 67% of patients with stroke, epilepsy and Chronic Obstructive Pulmonary Disease (COPD) which already exceeded the local commissioning network goal of 65% by the end of March 2016.

• The practice hosted a diabetic speciality clinic every three months with support from a specialist diabetic nurse and the lead diabetic lead at the practice.

• The practice offered prostate cancer management and follow-up service which was in line with the Shared Care guidelines. The service was operated by a GP and lead practice nurse within the surgery and offered hormonal injections as well as care planning and recalls and reviews. In the preceding 12 months the practice had administered 74 therapy injections and had a current register of 24 patients. Satisfaction with the service amongst patients was high with all patients rating the care as either good or excellent in a survey carried out in 2015.

Updated 25 May 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.

• The practice developed and ran a weekly confidential teenage only clinic at the main surgery for children and young people. This offered confidential parent/carer free service and was held in a separate area away from other patients. In the preceding 12 months 65 young people attended these clinics for health advice and treatment. The practice had in place processes with regard to ensuring safeguarding controls and Fraser and Gillick competences were met.

• Immunisation rates were high for all standard childhood immunisations.

• There was the facility for children to have walk-in/urgent access to see a GP. Additionally appointments were available outside of school hours.

• The practice held weekly baby clinics with three separate sessions being available.We saw positive examples of joint working with midwives, health visitors and school nurses.

• The practice participated in the C-Card scheme which gave access to contraceptives to young people.

Updated 25 May 2016

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

• The practice held regular multi-disciplinary team meetings with partners which included meetings to avoid unplanned admissions and as part of the Connecting Care programme.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

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

• Since 2013 patients over 55 could attend a weekly audiology clinic which was hosted by the practice.This allowed testing and the fitting of a hearing aid in one appointment. Between 2013 and 2015 356 patients  accessed the service and waiting times were reduced from up to six months when delivered previously at a local hospital to two to four weeks for the in-house  service. Since April 2015 this service was also  extended to those aged 19 years and over.

Updated 25 May 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 early morning GP and practice nurse appointments from 7am and Saturday morning surgeries on alternate weeks at the main surgery.

• The practice offered online appointment booking and repeat prescription requests could be made in a variety of ways such as via a visit to the surgery or via the post or on line. Prescriptions could also be sent direct to the patient’s chemist of choice via the Repeat Dispensing Service and E-Prescribing.

• The practice was proactive in offering a range of health promotion and healthy lifestyle services which included access to health trainers and signposting to support groups.

Updated 25 May 2016

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

• The practice had planned and proactively carried out dementia screening to identify at risk patients who may have a cognitive impairment. It had identified 794 at risk patients from the patient list and invited them in for screening, of these patients 285 had accepted and had screening carried out. Of these patients 29 were identified as having a cognitive impairment and were offered support including access to a memory clinic, an additional eight patients had been identified through opportunistic screening.

• A counsellor held weekly sessions at the practice which offered Improving Access to Psychological Therapies (IAPT) and these were accessed by referral from a GP (IAPT offers a particular type of counselling, recommended by NICE, that has been developed to help people suffering from depression).

• 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 advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• Staff had a good understanding of how to support patients with mental health needs and dementia, and the majority of staff had received additional  dementia friendly training. The practice had also made a successful bid to the Dementia Innovation Fund to improve surgery facilities for dementia patients and their families, and held a dementia awareness open day in September 2015 with partners to increase understanding of the condition within the community.

Updated 25 May 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 and had appointed lead GPs for both childrens and adults safeguarding.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff at both sites 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.

• Patients with a learning disability were offered an annual health review.

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

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• The practice was registered with the Wakefield Safer Places Scheme. This aimed to assist vulnerable people with their day to day out of home living.

• The practice serviced the health needs of a local home for vulnerable teenagers and three sheltered housing developments.