Archived: Holycroft Surgery Also known as Modality Partnership

Updated 10 March 2016

Holycroft Surgery is a mixed urban and rural practice located in Keighley, West Yorkshire. The area is in the third most deprived nationally and serves a patient list of 10,329 people. The practice is located on a single site in the centre of the town and shares the premises with other community health services, such as district nurses and health visitors. The practice has 40 staff members including five GP partners, four salaried GPs (male and female GPs), a physician’s assistant, a practice pharmacist, four practice nurses and two healthcare assistants.

The practice is open between 8am and 6pm Monday to Friday. Appointments are from 8.30am to 1pm every morning and 2pm to 6pm daily. Extended hours surgeries are offered at the following times every Monday and alternate Tuesdays 6.30pm to 8.30pm weekdays.

Out of hours care is provided by Local Care Direct

We visited the single site premises at Keighley Health Centre, Oakworth Road, Keighley.

Updated 10 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Holycroft Surgery on 9 December 2015. The practice is rated as good for safe, effective, caring, responsive and well-led. The overall rating is 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.
• Patients said they While urgent appointments were available on the same day, patients have said that they found it was not easy to make an appointment. The practice reports that it has a clear plan to improve access for patients., 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 the following areas of outstanding practice:

• The practice has a well developed auditfunction and was awarded in 2015 the first Research and Engagement award from the National Institute of Health Research (NIHR). This has helped the change in culture of the surgery to one where research is part of everyday clinical practice

• The PPG has identified individuals who take champion roles that are related to specific and commonconditions such as osteoporosis .This helps to encourage patients to attend specific clinics and receive treatement.Through this the practice had ensured that all (100%) of its patient who had osteoporosis were taking calcium supplements.

• The PPG actively participate in clinical activities for example they support the practice staff to ensure the smooth running of flu clinics by guiding patients through the process.

• The practice were holders of the Government Standard Customer Service Excellence Award.

• The practice offer Tailored Long term Care (TLC) ensuring patients are supported to access timely reviews for their long term conditions. Patients are provided with a personalised action plan recording results and jointly agreed goals.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 March 2016

The practice is rated as 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.

• Over 84% of patients with diabetes have a blood sugar reading within normal range in the preceding 12 months, compared to nationally 77.72%.

• Almost 98% of patients on the diabetes register received the influenza immunisation in the preceding September to March period, compared to 93.46% nationally

• Longer appointments and home visits were available when needed.

• All these patients 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 GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

• The practice offers Tailored Long term Care (TLC) ensuring patients received bespoke individual care.They were supported to access timely reviews for their long term conditions. Patients worked in partnership with practice clinical staff and were provided with a personalised action plan recording results and jointly agreed goals.This approach has resulted in significantly better than CCG and national average outcomes for patients.

Updated 10 March 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. Immunisation rates were relatively high for all standard childhood immunisations.

• 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.

• The percentage of women aged 25 to 64 years who had a cervical screening recorded as being performed in the preceding five years was 87.1%, higher than the national average of 81.88%.

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

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

Updated 10 March 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.

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

Updated 10 March 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.

Updated 10 March 2016

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

• 77.55% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan documented in the record, in the preceding 12 months was 91.84%, compared to a national average of 86.04%.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• It 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.
• It 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 people with mental health needs and dementia.

Updated 10 March 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 homeless people, travellers and those with a learning disability.

• It offered longer appointments for people with a learning disability.

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

• It had 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.