Background to this inspection
Updated
21 February 2019
Wenlock Terrace Surgery, 18 Wenlock Terrace, York, North Yorkshire, YO10 4DU, also known as Unity Health () provides general medical services to approximately 23,000 patients in the Fulford, Heslington and Osbaldwick areas of York.
Services are also provided from a branch practice that opened in March 2018 at Kimberlow Hill Surgery, Kimberlow Rise, York, North Yorkshire, YO10 5LA. This branch practice is sited on the University of York campus and as such has a high population of patients who are students, including international students (65%).
All patients can be seen at any of these locations. We visited both locations on 8 January 2019 as part of our inspection.
Most patients are aged between 18 and 44 years of age, with 53% of patients between the ages of 16 to 24. The index of multiple deprivation score for this practice population is 10 which means that it is in one of the least deprived areas and lower than average for England.
At the time of the inspection there were three Clinical GP Partners (two male and one female and one Managing Partner, plus five salaried GPs and two long term locum GPs. There were five practice nurses, two health care assistants (HCAs) and a phlebotomist. There was a pharmacist and a mental health therapist/ counsellor. They were supported by a data manager, office manager, two secretaries, five administration staff and nine reception staff.
The provider is registered for the provision of the following regulated activities from both locations:
• Diagnostic and screening procedures
• Family planning
• Maternity and midwifery services
• Surgical procedures
• Treatment of disease, disorder or injury
The practice at Wenlock Street Surgery is open from 8am to 6pm Monday to Friday. The Kimberlow Hill Surgery is open from 8am to 6pm with extended hours on Monday to Thursday from 6pm to 8pm and on Saturday from 9am to 1pm.The practice were part of a GP federation Nimbuscare Ltd and as such patients registered at the practice could access appointments at weekends and evenings at four hubs in the area. This was as part of the improving access scheme which started in October 2018. Out of Hours care is provided by Vocare in York via the 111 telephone number.
Updated
21 February 2019
This service is rated as good overall. (Previous inspection on 23 May 2018 – Inadequate)
The key questions are rated as:
Are services safe? – Good
Are services effective? – requires improvement
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Good
We carried out an announced comprehensive inspection at Wenlock Terrace Surgery on 23 May 2018 the overall rating for the service was inadequate.
This service was placed in special measures in July 2018. The full comprehensive report on the May 2018 inspection can be found by selecting the ‘all reports’ link for Wenlock Terrace Surgery on our website at .
A further focussed inspection was undertaken in September 2018, where we followed up concerns from the two warning notices and condition on registration we had issued.
That re-inspection was not given a rating but we were satisfied that risks had been sufficiently reduced at that time. This inspection was an announced comprehensive inspection carried out on 8 January 2019 to confirm that the service had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspections.
Overall the service is now rated as good overall, and requires improvement for effective service. We rated the population groups of older people, children, families and young people, working age people (including those recently retired and students) and people experiencing poor mental health as requires improvement, people with long term conditions as inadequate and people whose circumstances make them vulnerable as good.
Our key findings were as follows:
- The provider encouraged reporting of incidents. This had increased the effectiveness of reporting, lessons learned and feedback to staff
- The practice had systems in place to manage risk so that safety incidents were less likely to happen.
- There was limited monitoring of the outcomes of care and treatment.
- Some performance data was significantly below local and national averages.
- There were arrangements in place to review the effectiveness and appropriateness of the care being provided.
- Arrangements for monitoring and reviewing prescribing helped ensure that patients were kept safe.
- Arrangements were in place to ensure that staff were working within the scope of their competency. Staff received appropriate support, training, professional development and appraisal as was necessary to carry out the duties they are employed to perform
- During our inspection we saw that staff treated patients with compassion, kindness and respect.
- Arrangements for the identification of carers and offer of support had improved.
- Patients and staff told us that making an appointment to see a clinician was easier but telephone access was still sometimes difficult.
- The practice had established a system for identifying, receiving, recording, handling and responding to complaints by patients.
- Governance arrangements were being operated effectively to ensure the delivery of care.
The areas where the provider should make improvements are:
Embed the improvements already made.
Continue to monitor care and treatment for patients as planned and provide regular reviews and assessment of needs in line with evidence based guidance.
Improve the uptake of cervical cancer screening for eligible women.
Improve the telephone system to improve access to appointments.
I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by this service.
Professor Steve Field CBE FRCP FFPH FRCGPChief
Inspector of General Practice