Meltham Road Surgery

Updated 29 November 2016

The Meltham Road Surgery, located at 9 Meltham Road, Lockwood, Huddersfield, HD1 3UP, is a busy urban practice, located a short distance from the centre of Huddersfield. The purpose built premises offer good facilities and are fully accessible.

It has a patient list of 9,500, which is mainly White British. The practice has approximately 20% of patients who are of South Asian descent. Typically for this area, there are higher levels of deprivation compared to the national average and there are a greater proportion of younger patients.

The practice has a longstanding and stable staff structure. The surgery has five GP partners (two male and three female) and one salaried assistant doctor (female). The provider has not yet submitted an application for the addition of the fifth partner and we have advised them to make the necessary application to us without delay. Two of the partners work full time and the other GP partners work 0.75 whole time equivalent. The salaried assistant doctor offers two sessions each week specialising in acupuncture. Surgeries are offered throughout the day. The nursing team is led by a part time Advanced Nurse Practitioner and three part-time practice nurses who are also supported by a health care assistant (all female). The practice manager leads an administrative team that includes 15 mostly part time administrative staff including several secretaries and a medical records summariser.

The practice provides service through a Primary Medical Services (PMS) contract. The provider is both training and teaching practice and hosts medical students and qualified doctors training to work in general practice.

The practice is open from 8am to 6pm Monday to Friday, except on Tuesday when reception and pre-booked appointments are available until 8.30pm. Both a male and female GP are available for Tuesday evening consultations. Out of hours care is provided by Local Care Direct.

Updated 29 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Meltham Road Surgery on 25 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.
• Families suffering bereavement were offered a home visit and directed to support from local support services.
• 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 same day telephone call backs and urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs. Services offered included an anticoagulation clinic for people needing regular blood checks and an in-house audiology (hearing) clinic managed by a practice nurse.
• There was a clear leadership structure and staff felt highly supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• Communication was promoted through a regular newsletter.
• 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 their recruitment arrangements to assure themselves that all necessary employment checks are completed for all staff prior to them commencing employment with the practice.

• Review their infection prevention and control policy to assure themselves that risks are assessed and necessary safeguards are implemented.

• Review their rate of clinical exception reporting to assure themselves that all reporting is in line with nationally agreed exception reporting criteria.

• Review their business continuity plan to assure themselves that all necessary contingencies have been considered.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 29 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.

• 82% of newly diagnosed diabetic patients were referred to a structured education programme within nine months following diagnosis. This was 10% higher than the national average.

• 87% of diabetic patients had received a foot examination in the last year which was 5% 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 29 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.

• Family planning services included the provision of contraceptive coils and implants.

• 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 80%, which was slightly below 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. A weekly infant welfare clinic for pre-school children was facilitated by a GP, practice nurses, health visitor and nursery nurse to provide holistic support for families.

Updated 29 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.

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

• The practice undertook a weekly visit to a local nursing home with a named GP to review patients in addition to any urgent home visits.

• 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 29 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.

• Appointments were available until 8.30pm for people unable to attend during the day.

• 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 29 November 2016

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

• 79% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the local and national averages.

• 92% of patients experiencing serious mental illness had an up to date care plan in place. This was 8% higher than the local average and 15% higher than the national average and had been achieved with an exception rate that was also 9% 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 offered longer appointments for patients experiencing mental illness.

• 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 29 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 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.

• Staff had received training in dementia awareness.