Lockwood Surgery

Updated 13 July 2016

Lockwood Surgery is situated in Hudddersfield, HD1 3XH. It is located approximately one and a half miles from Huddersfield town centre. There are currently 4746 patients on the practice list. 78% of patients are of white British origin, with the remaining 22% being of South Asian, Eastern European or Afro-Caribbean origin. The practice provides Personal Medical Services (PMS) under a contract with NHS England. They offer a range of enhanced services such as childhood vaccinations and immunisations, avoiding unplanned admissions scheme and minor surgery.

The practice is situated in a purpose built two storey building. The building has car parking facilities, disabled access, and access to public transport routes.

The practice has three GP partners, two of whom are male and one female. There are two female practice nurses and one female health care assistant (HCA). The clinical team is supported by a practice manager and a range of administrative and secretarial staff.

The practice catchment area is classed as being within the group of one of the more deprived areas in England. People living in more deprived areas tend to have greater need for health services.

The average life expectancy for patients registered at the practice is 76 years for men and 81 years for women, compared to the local average of 78 years and 82 years respectively, and the national average of 79 years and 83 years respectively.

The practice had identified 20% of their patients as over 65 years old, with 9% over 75 years old, and 2% of their patients were living in residential or nursing homes.

The practice is open between 8.30am and 6.30pm Monday to Friday.

Weekly clinics are held which include contraception, childhood immunisations and phlebotomy.

Out of hours care is provided by Local Care Direct which is accessed by calling the surgery telephone number or by calling the NHS 111 service.

Updated 13 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Lockwood Surgery on 14 June 2016. The practice has received an overall rating of 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 the same day.
• In the most recent national patient survey patients had rated this practice proportionately better than other practices in terms of access and their experience of the service as a whole.
• The practice had good facilities and was well equipped to treat patients and meet their needs.

• The practice was registered as a ‘Safe Place’.This meant that they had undertaken to support vulnerable people if they became disorientated or lost; and make contact with key people to ensure that they were safely returned home.

• 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.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw an area of outstanding practice:

• The practice provided a weekly surgery at all the nursing homes where they had patients registered. This service had been continued despite CCG funding having been withdrawn.

  We saw one area where the provider needs to make improvements. The provider should:

• Develop a system for checking disclosure and barring service (DBS) status of locum GPs

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 13 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.

• 95% of patients with diabetes, on the register had received a flu immunisation in the preceding 12 months compared to 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.

• The practice made use of care plans for patients with long term conditions. This ensured that patients were involved in planning and managing their own health.

• The practice made referrals to the ‘Practice Activity and Leisure Scheme’ which enabled eligible patients to attend local gyms and undertake an individualised activity and fitness plan to help in managing their condition.

Updated 13 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 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.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• Practice staff provided examples of effective joint working with midwives and health visitors.

• The health visitor attended a monthly meeting at the practice, where children who had been identified as having additional needs were discussed, and care planning was updated.

• At the time of our visit nine children were subject to a child protection plan, and 10 to a child in need plan. These are where health, social care and other professionals work together to help keep children safe from harm.

• The practice followed up all women during their pregnancy, up until the child reached school age; and ensured that appointments for vaccinations and immunisations were sent in a timely way. Where patients failed to attend for appointments they were routinely followed up by practice staff.

Updated 13 July 2016

The practice is rated as good for providing caring and responsive services to 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.

• Before the inspection we sought feedback from two nursing homes who had residents registered at the practice. Both homes told us they received an excellent service from the practice.

• The practice provided a weekly surgery to all the nursing homes where they had patients registered. This service had continued despite the additional funding having been withdrawn. This meant that problems could be picked up earlier, residents received continuity of care, and were able to access GP services in a similar way to patients living in their own home. They told us this had reduced the number of people being referred to secondary care in urgent circumstances.

• The practice showed that as a result of their work with nursing homes that the proportion of expected deaths occurring at home had increased significantly. This showed that patients were more likely to end their lives at their place of choice and in familiar surroundings, rather than in hospital.

Updated 13 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.

• 95% of elegible women had received a cervical smear screening in the preceding five years compared to the national average of 82%.

• 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.

• We saw that 34% of patients had registered for online access.

Updated 13 July 2016

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

• 86% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average of 84%.
• 100% of patients with mental or physical health conditions had their smoking status recorded, compared to the national average of 94%.

• The practice regularly worked with multidisciplinary 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 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.

• The practice told us that before referring patients for diagnostic confirmation of dementia they carried out a range of pre-diagnostic checks such as blood tests, computerised tomography (CT) scan and electrocardiogram (ECG) testing to help ascertain a speedy diagnosis.

• Where patients were known to have difficulty with memory the practice had a system of making a call to patients half an hour before their allotted appointment time to remind them of the appointment

Updated 13 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 including those with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice gave vulnerable patients information about how to access various support groups and voluntary organisations.

• The practice had identified a Carer’s Champion. A Carers’ Open Day had been held at the practice the week before our visit. Carers were signposted to ‘Carers Count’ which was a local support agency. We spoke with one carer during our visit who told us they received good support from this organisation. This group of patients were offered an annual health check and seasonal flu vaccination each year.

• The practice was registered as a ‘Safe Place’. This meant that they had undertaken to support vulnerable people if they became disorientated or lost; and make contact with key people to ensure that they were safely returned home.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were able to give good examples of how they had effectively identified children and adults at risk of harm and had shared information and documented concerns. We saw that contact details for the relevant agencies, both in working hours and out of hours were available to staff.