MyHealth

Updated 18 July 2016

MyHealth group practice provides a General Medical Service (GMS) to their practice population of over 18,000 patients. They are also contracted to provide other enhanced services for example: extended hours access and minor surgery. They have four health care centres across a semi-rural area to the North East of York.

There are 11 GP partners (5 female and 6 male). There is one Managing Partner who is supported by five senior managers. This is a teaching and training practice. The medical students are from Hull & York Medical School. In addition there are places for qualified doctors who wish to train as GPs. There are currently three GP registrars from the York Vocational Training Scheme (male & female). There are six female practice nurses, one Care in the Community Co-ordinator, one Advanced Nurse Practitioner and three female healthcare assistants (one who is an apprentice). There are 26 clerical and administrative support staff who support the clinical staff; their roles included receptionists, dispensers, and secretaries.

Each Health Care Centre opens at different times and offers appointments times to reflect the needs of their practice population. All patients can attend any centre however most attend close to their residence for continuity of care. Strensall Health Care Centre is open Monday to Friday from 8am until 6pm. Appointments are available from 8.30am until 11am and 3pm until 5.30pm. There is a walk in clinic for acute problems, Monday – Friday, 8.30am -11am held at Strensall Health Care Centre. They also have extended hours on Monday from 6.30pm -7.30pm and each Saturday morning from 8.30am until 10.30am.

Stamford Bridge Health Care Centre is open Monday to Friday from 8am until 6pm. They close for lunch from 12.15pm until 1.45pm. Appointments are available Monday to Friday from 8.30am until 11am and from 3pm until 5.30pm. There is extended hours opening each Thursday from 6.30pm until 7.30pm.

Huntington Health Care Centre is open Monday, Tuesday, Wednesday and Friday from 8.30am until 6pm, they close for lunch between 12.15pm and 1.45pm on these days. They are open on Thursday from 8.30am until 12pm only. Appointments are available from 8.30am until 11am each morning and from 3pm until 5.30pm every afternoon but Thursday.

Dunnington Health Care Centre is open on Monday, Wednesday and Thursday from 8.30am until 6pm closing for lunch from 12.15pm until 1.45pm. Appointments are available on these days from 8.30am until 11am and from 3pm until 5.30pm. On Tuesdays and Fridays this centre is open from 8.30am until 12pm; appointments are available from 8.30 am until 11am.

Updated 18 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at MyHealth Group Practice on 1June 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.
• 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 each day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by their immediate managers. 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. The partners encouraged a culture of openness and honesty.

There were areas of practice where the provider needs to make improvements,

the provider should:

• Review the management and storage of controlled drugs to ensure they meet with legislative requirements.

• Review the training of dispensary staff to ensure the recording and documentation in the controlled drug register meets legislative requirements.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 July 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. All patients had care plans in place.

• The practice provided ‘MyHealth Station’ (where patients could monitor their blood pressure and weight) which helped patients with long term conditions feel able to self-manage their condition or work in partnership with their clinician. The information was sent directly to the patient’s notes for the clinician to review.

• The percentage of patients with diabetes, on the register, in whom the last IFCC-HbA1c was 64 mmol/mol or less in the preceding 12 months (01/04/2014 to 31/03/2015) was 83% which was similar to the CCG average of 82% and higher than the national average of 77%.

• The percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) was 140/80 mmHg or less (01/04/2014 to 31/03/2015) was 81% which was higher than the CCG average of 77% and the national average of 78%.

• The percentage of patients with diabetes, on the register, who had had influenza immunisation in the preceding 1 August to 31 March (01/04/2014 to 31/03/2015) was 97% compared to the CCG average of 96% and the national average of 94%.

• 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 18 July 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 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.

• The percentage of women aged 25-64 whose notes record that a cervical screening test had been performed in the preceding 5 years (01/04/2014 to 31/03/2015) was 81% which was similar to the CCG average of 81% and very slightly lower than the national average of 82%.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, health visitors and school nurses.

Updated 18 July 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. Patients aged 70 and above represented 15% of the practice’s patient population. All patients over the age of 75 had an accountable GP.

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

• The practice had introduced the role of Community Care Co-ordinator (an Independent Nurse Prescriber) to work closely with nursing and residential homes and housebound patients; alongside the GPs who had designated responsibility for specific homes.

• There were care plans for patients over the age of 75 and those at high risk of hospital admission.

• The practice had worked with the CCG on referrals and admissions and were involved in the Integrated Care Team Pilot (Priory Medical Group) which now included other GP practices within the Vale of York. The aim was to reduce hospital admissions and assure safe hospital discharge in a timely manner.

Updated 18 July 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.

• This included a range of appointment lengths, times, and formats with Monday (at Strensall) and Thursday (at Stamford Bridge) providing extended hours sessions. In addition there were weekly Saturday morning pre-bookable appointments (at Strensall). In addition there were appointments before work, telephone appointments and email consultations readily available.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs of this age group.

Updated 18 July 2016

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

• 93% of patients diagnosed with dementia had, had their care reviewed in a face to face meeting within the last 12 months, which was better than the CCG average of 85% and also better than the national average of 84%.

• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months (01/04/2014 to 31/03/2015) was 87% which was lower than the CCG average of 92% and lower than the national average of 88%.

• 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 how to access various support groups and voluntary organisations.

  The ‘Walk in Clinic’ service for urgent issues with face to face and telephone appointments available allowed staff to prioritise management of patients in mental health crisis.

• 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 18 July 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 and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• 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.