Archived: The Lindley Village Surgery

Updated 10 April 2017

Dr Iqbal Ahmed Khan (The Lindley Village Surgery), Thomas Street, Lindley, Huddersfield, HD3 3JD, provides services for 4,807 patients. The provider operates from one location situated within the Greater Huddersfield Clinical Commissioning Group and delivers primary medical services under the terms of a personal medical services (PMS) contract.

Services are provided within a purpose built and accessible building. The location is leased from a private landlord. The provider is located in a rural area of Huddersfield.

The population experiences lower than average levels of deprivation and is mainly White British.

Dr Iqbal Ahmed Khan (The Lindley Village Surgery), is registered to Dr Iqbal Ahmed Khan. The partner and three locum GPs (two male and one female) work full time. The provider also has an advanced nurse practitioner (female) and three nurses who work full time. The practice also has a part time female practice nurse, a pharmacist and two health care assistants.

The practice manager is supported by 13 part time reception and administrative staff.

The practice opening times are as follows:-

Monday 8:15am to 6pm

Tuesday 8:15am to 6:00 pm (Extended Hours Clinic 6:30pm to 8pm)

Wednesday 8.15am to 6pm

Thursday 8:15 am to 12:30pm (Extended Hours Clinic 7:30am to 8:30am)

Friday 8:15am to 6pm

Weekends Closed

Telephone Lines open every day at 8.15am to book appointments.

The practice is closed on Thursday afternoons from 12:30pm. If patients require an emergency or urgent appointment after this time they can call another local practice is used to cover emergencies when the practice is closed on a Thursday afternoon.

When the surgery is closed patients are advised of the NHS 111 service for non urgent medical advice and are directed to a local out of hours provider, Local Care Direct.

Updated 10 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Iqbal Ahmed Khan (The Lindley Village Surgery) on 14 March 2017. 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. A full practice meeting which included safety alerts was held at the practice each month to review any concerns.
• Risks to patients were assessed and well managed.
• The practice had good facilities and was well equipped to treat patients and meet their needs.

• 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 implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from the patient participation group. For example, improving the appointment and telephone answering systems by having more staff available to take calls at busy times.
• 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. For example, stopping the baby clinic and moving to an ‘as and when required’ system. As a result mothers with babies could attend the practice any time for childhood immunisations.
• The provider was aware of and complied with the requirements of the duty of candour and had a clear policy statement. In addition, a policy called Being Open underpinned their approach to honesty and integrity, ensuring that all staff were aware of their duty of care.

The area where the provider should make improvement:

• Continue to address the low number of carers on the practice register to assure themselves that carers are aware of support available to them.
• The provider should re-evaluate the complaints policy to address the timeline of correspondence.
• Ensure all clinical equipment at the practice is in date to ensure it is working properly. For example blood glucose test strips (diabetes test strips) should be in date, also needles and skin cleansing pads.
• Review monitoring of patient care to ensure that patients are included in data which indicates whether appropriate care is received. The quality outcomes framework (QOF) reporting indicated monitoring of patient care and treatment was not always recorded.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 April 2017

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 diabetes was 33% lower than the local average and 34% lower than the national average and was achieved with lower than average exception reporting. The quality outcomes framework (QOF) reporting indicated monitoring of patient care and treatment was not always recorded. By evaluating QOF results and investigating coding issues should improve the QOF data score.
• 62% of patients with asthma received an annual review which was 36% lower than the local average and 36% lower than the national average and was achieved with lower than average exception reporting of 4% which was 6% lower than the local average and 6% below the national average. The practice had carried out these reviews and a recording error was the reason for the low score.
• Longer appointments and home visits were available when needed. The practice combined reviews wherever possible to minimise the number of appointments required and sent text reminders to patients.
• 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 or advanced nurse practitioner worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 10 April 2017

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.
• A full range of family planning services were provided and sexual health support for young people was offered, including chlamydia screening.
• Uptake for the cervical screening programme was 80%, which was lower than 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 10 April 2017

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.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. Housebound patients were supported by clinical staff offering long term conditions and medication reviews in the patient’s own home.
• The practice offers medications reviews to five local care homes with registered patients with the practice.

Updated 10 April 2017

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 appointments were offered one day a week (Thursday) and late appointments on Tuesday for people unable to attend the surgery during the standard working day. Appointments could be booked by telephone, online or by email.

Updated 10 April 2017

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

• 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. A GP partner had a special interest in supporting patients experiencing mental illness.
• 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 10 April 2017

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.
• Patients with a cancer diagnosis or a serious mental illness were followed up by the practice if they missed an appointment.
• The practice offered longer appointments for patients with a learning disability and undertook annual reviews in their home environment if indicated as preferable.
• 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.