Archived: The Junction Surgery

Updated 24 November 2016

The Junction Surgery, Birkhouse Lane, Moldgreen, Huddersfield HD5 8BE provides services for 5350 patients. The surgery is situated within the Greater Huddersfield Clinical Commissioning Group and provides primary medical services under the terms of a general medical services (GMS) contract. The provider is also a training practice for medical students and has made an application to become a training practice for doctors wishing to specialise in general practice. Services are provided within a purpose built and accessible building which is owned by the partners. The practice covers the areas of Moldgreen and some surrounding villages. The population experiences average levels of deprivation and the population is mainly White British. The Junction Surgery is registered as a partnership between Dr Razwan Ali and Dr Aneesha Ahmad. Dr Ali (male) works full time and Dr Ahmad (female) works half time. They are supported by two salaried GPs (one male and one female) who both work half time. The practice also has two part time female practice nurses equivalent to one whole time post. The practice manager is supported by reception and administrative staff and a cleaner is also directly employed.

The practice reception is open Monday to Friday from 8am to 6.30pm, with closure on a Wednesday afternoon. However, a GP remains on call until 6.30pm to respond to any urgent queries. Pre-booked appointments are also available from 6.30pm-8pm on Monday and from 6.45am on Wednesday. Out of hours treatment is provided by Local Care Direct.

Updated 24 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Junction Surgery on 12 July 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 named 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 had developed a staff reward scheme that recognised excellent service to patients and examples of good teamwork across the practice. Staff and patients were encouraged to make nominations with a reward offered on a regular basis for those staff who were achieving good feedback.

• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Review the carers register for coding errors to ensure an accurate database is maintained.

• Review the current policy for patient bereavement support.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 24 November 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 and patients at risk of hospital admission were identified as a priority.

• Overall QOF achievement for treatment of chronic lung disease and diabetes was 6% higher than the local average and 4% higher than the national average.

• 95% of newly diagnosed diabetic patients were referred to a structured education programme within nine months following diagnosis. This was 24% higher than the national average.

• 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.

Updated 24 November 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 accident and emergency (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.

• Uptake for the cervical screening programme was 83%, which was comparable to the CCG average of 85% and the national average of 81%.

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

We saw positive examples of joint working with midwives and health visitors.

Updated 24 November 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. This included a daily visit to a local nursing home by a GP.

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

• The practice actively monitored patients at risk of hospital admission, undertook reviews of patients on multiple medications and liaised with other agencies for effective end of life care.

Updated 24 November 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.

• Early morning and late evening appointments were available for people that needed them.

• 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 24 November 2016

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

• 89% of patients diagnosed with dementia had had their care plan reviewed in a face to face meeting in the last 12 months, which was 5% higher than the national average.

• 100% of eligible patients experiencing a serious mental illness had an up to date care plan. This was 11% higher than the national average and had been achieved with an exception rate that was also 7% lower than the national average.

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

• 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 24 November 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 and those with a learning disability.

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

• 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.