Archived: Lavender Grove Surgery Also known as Priory Medical Group

Updated 25 June 2015

Lavender Grove Surgery provides primary medical services to approximately 5,400 patients in the York Clinical Commissioning Group (CCG) area. They are part of the Priory Medical Group (PMG) which is a General Practice Partnership open to all patients living within the Practice boundary in York and the surrounding areas.

The PMG has nine practices in the York area and are responsible for a population of 54120. Patients registered with PMG can at attend any of the nine surgeries if this is more convenient.

At this practice, there are five GP’s, four female and one male. Patients can be seen by a male or female GP as they choose. There is a practice nurse and a healthcare assistant based at the practice, and a team of other nursing staff who divide their time between surgeries. They are supported by a team of management, reception and administrative staff. The practice is a training practice and supports a GP registrar and third year medical students.

The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of diagnostic and screening procedures; family planning; surgical procedures, and treatment of disease, disorder and injury. The practice has a mixed demographic and covers some more affluent and some more deprived areas.

The practice has opted out of providing Out of Hours services, which patients access through the 111 service.

Updated 25 June 2015

Letter from the Chief Inspector of General Practice

This is the report of findings from our inspection of Lavender Grove surgery which is part of the Priory Medical Group. The practice is registered with the Care Quality Commission to provide primary care services.

We undertook a planned, comprehensive inspection of Lavender Grove surgery on 4 December 2014. There are nine surgeries in the Priory Medical Group (PMG) across the York Clinical Commissioning Group (CCG) area.

Overall, we rated this practice as good.

Our key findings were as follows:

• The practice provided services to the local community, which had been designed to meet the needs of the local population. Patients registered with this practice are

able to access all services at the other nine practices in the Priory Medical Group (PMG).

• Patients told us they were treated with dignity and respect.
• The practice performed well in the management of long term conditions.
• Patients could access appointments without difficulty, and were happy with the telephone and repeat prescribing systems.
• The practice had a good governance system in place, was well organised and actively sought to learn from performance data, complaints, incidents and feedback.
• The building was safe for patients to access, with sufficient facilities and equipment to provide safe effective services.

We saw some areas of outstanding practice including:

• Enhanced care plans and communication/education with care homes including twice weekly ward rounds.
• There was a dedicated teenage health clinic one evening per week, which had been designed with the help of pupils from two local schools, to make the clinic as teenage friendly as possible.
• There was an in-house educational programme, where clinical staff could access evening training meetings every six weeks or so. There was also multi‐disciplinary learning for nurses, health care assistants and doctors. Health visitors were also invited to attend. These took place during the day and protected time was allowed for staff to attend three per year.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 June 2015

The practice is rated as good for the care of people with long term conditions. People with long term conditions were monitored and discussed at multi-disciplinary clinical meetings so the practice was able to respond to their changing needs. Information was made available to out of hours providers for those on end of life care to ensure appropriate care and support was offered. People with conditions such as diabetes and asthma attended regular nurse clinics to ensure their conditions were monitored, and were involved in making decisions about their care. Nurses communicated with a clinical lead GP for each condition. For those people with the most complex needs, the named GP and or specialist nurses worked with relevant health and care professionals to deliver a multidisciplinary package of care. The staff had received appropriate training in the management of long term conditions. Attempts were made to contact non-attenders to ensure they had required routine health checks.

Updated 25 June 2015

The practice is rated as outstanding for the care of families, children and young people. Systems were in place to identify children who may be at risk. For instance, the practice monitored levels of children’s vaccinations and attendances at A&E. Immunisation rates were high for all standard childhood immunisations. Appointments were available outside of school hours and the premises were suitable for children and babies. Antenatal clinics were run by district midwifes with most care delivered at the practice.

The PMG have developed a teenage health clinic, and had consulted with students from two local schools to make the clinic teenage friendly. Services were provided for 11 to 19 year olds with booked appointments and a drop in service one evening a week. This ensured that young people had access to an age appropriate, dedicated service. There was a dedicated area on the website for advice and health promotion information for teenagers. The practice carried out a daily surgery at a local independent boarding school in its area.

Updated 25 June 2015

The practice is rated as outstanding for the care of older people. The practice participated in a nursing home scheme where GP’s visited the local nursing home to carry out a ‘ward round’ twice a week. This was rotated between all GPs with protected time allowed for this. The practice held monthly palliative care and multi-disciplinary meetings to discuss those with chronic conditions or approaching end of life care. Enhanced care plans had been produced for those patients deemed at most risk of an unplanned admission to hospital. Information was shared with other services, such as out of hours services and district nurses. Nationally reported data such as the Quality and Outcomes Framework (QOF) showed the practice had good outcomes for conditions commonly found in older people. The over 75’s had a named GP. The practice was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. All doctors, nurses and receptionists had carried out training to be ‘Dementia Friends’ and promoted dementia awareness within the practice.

We saw that personalised care plans had been developed for patients who were at risk. The PMG provided a team of community nurses in partnership with NHS York District Hospital Foundation Trust. This group provided nursing support and assessments to housebound patients seven days a week. The PMG were responsible for implementing a community team which was made up of care managers and health and social care assistants to support patients and assess patient’s needs. This helped patients remain independent and avoid unnecessary admission to hospital.

Updated 25 June 2015

The practice is rated as good for the care of working age people (including those recently retired and students). The needs of the working population had been identified, and services adjusted and reviewed accordingly. Routine appointments could be booked in advance, or made online. Repeat prescriptions could be ordered online. The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group. We saw that the practice provided a range of services patients could access at times that best suited them or close to their work by accessing an evening or Saturday morning appointment in one of the other practices within the PMG.

Updated 25 June 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Nationally reviewed data showed the practice performed well in carrying out additional health checks and monitoring for those experiencing a mental health problem. People experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It also carried out advance care planning for patients with dementia. Staff had received training on how to care for people with mental health needs and dementia, with a number of staff being trained as ‘Dementia Friends’.

Updated 25 June 2015

The practice is rated as good for the care of people living in vulnerable circumstances. The practice had a register of those who may be vulnerable, including those with learning disabilities, who were offered annual health checks. Patients or their carers were able to request longer appointments if needed. The practice had a register for looked after or otherwise vulnerable children and also discussed any cases where there was potential risk or where people may become vulnerable. The computerised patient plans were used to flag up issues where a patient may be vulnerable or require extra support, for instance if they were a carer. Staff were aware of their responsibilities in reporting and documenting safeguarding concerns. We saw that the practice and medical group had also developed links with Lifeline. This is a project operating in the city that works with individuals, families and communities to prevent and reduce harm and promote recovery linked with alcohol and drug misuse.