Archived: Tang Hall Lane Surgery

Letter from the Chief Inspector of General Practice

We carried out a focused desktop inspection of Tang Hall Lane Surgery on 27 July 2016 to assess whether the practice had made the improvements in providing safe care and services.

We had previously carried out an announced comprehensive inspection at Tang Hall Lane Surgery on 3 February 2016 when we rated the practice as good overall. The practice was rated as requires improvement for providing safe care. This was because some non-clinical staff who undertook chaperone duties had not received a Disclosure and Barring Service check (DBS). (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable). The chaperone policy was re-written to assert that only clinicians who held a current DBS check would perform chaperone duties. We asked the provider to monitor, that the changes made to their chaperone policy were sustainable and that staff who performed this role would be DBS checked.

The provider was also asked to improve the access for patients to named GP to improve continuity of care.

We asked the provider to send a report of the changes they have made. The practice was able to demonstrate that they were meeting the standards. In addition patient access to named GP had improved as reflected in the July 2016 patient survey. We were told that the provider continued to trial different ways of working to improve continuity of care for their patients. The practice is now rated as good for providing safe care. The overall rating remains good.

This report should be read in conjunction with the full inspection report dated 31 May 2016.

Our key finding across the area we inspected was as follows:

The practice had clearly defined and embedded systems, processes and practices in place to keep patients safe and safeguarded from abuse. Patients were not disadvantaged by the changes to the chaperone policy and this was to be closely monitored to assure sustainability.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Tang Hall Lane Surgery on 3 February 2016. Overall the practice is rated as good. Tang Hall Lane Surgery is part of one large York provider (Priory Medical Group) who have nine locations. All patients can be seen at any of the locations; however, most attend one for continuity of their care.

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

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• 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.However some staff had not had the appropriate checks undertaken to carry out some specific duties. For example not all chaperones had had a DBS check .
• 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 were prepared to wait to have an appointment with a named GP and felt there was continuity of care.
• The practice had good facilities and was equipped to treat patients and meet their needs.
• There was a leadership structure and staff felt supported by the management team. 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 an area of outstanding practice:

• PMG employ a range of health care professionals (for example: registered nurses, care workers, physiotherapist and occupational therapists) to work as York Integrated Care Team (YICT). They also work with local authority social services (specific hours are allocated) and voluntary organisations. Their innovative approach, contacting patients who may be in need of support, assures appropriate support such as ‘step down care’ can be provided within two hours. This integrated person-centred care had enabled patients more choice with their care and support. The team reviews all hospital admissions and discharges each day. We saw that Non Elective Admissions(NEAs) were 5% lower than the CCG average and Accident and Emergency attendances(A&E)were 2.4% lower than CCG average. Some patients had become self-caring and had not needed further support from health and social care teams.

The area where the provider should make improvement are:

• To monitor the changes made to the chaperone policy are sustainable and that staff who undertake chaperoning are DBS checked.

• To improve the access to named clinicians for patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice