Archived: The Grove Surgery

Updated 25 February 2016

The Grove Surgery is based in a large modern building in central Wakefield and has a patient list of 9129. The practice has a diverse population, with 63% describing themselves as White British, 20% stating South Asian ethnicity and a growing East European demographic which is currently 11%. There is a small minority of Black and Middle Eastern ethnicity patients. The practice population are rated as experiencing average levels of deprivation when compared to local and national indicators.

The practice has five full time partners, four male and one female. There is a female salaried GP and the practice is also a training practice, the current GP registrar is male. There are four practice nurses that offer a whole time equivalent of 2.6 staff and they are complemented by two health care assistants who carry out a range of services including phlebotomy and ECGs (a type of heart assessment). The Grove Surgery has a practice manager and a comprehensive reception and administrative team. Care is provided through a Primary Medical Services contract commissioned by the Clinical Commissioning Group. Out of hours care is provided by Local Care Direct.

The practice is also part of a local network of practices that provide the Trinity Care service. This offers a nurse led triage service that provides access to GPs across seven days. The practice is open 8am to 6.30pm Monday-Friday with pre-booked GP appointments offered on a Saturday morning between 8am-12 noon.

Updated 25 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Grove Surgery on 15 September 2015. 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, recording and learning from significant events.
• Risks to patients and staff were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had 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. This was also available in a wide range of community languages.
• Patients said they found it generally easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day and a Saturday morning clinic for pre-booked appointments.
• 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 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, which is a legal duty to be open when harm is caused to a patient.

We saw several areas of outstanding practice:

• The practice was part of Trinity Care which offers a seven day, nurse-led telephone triage service for same day GP appointments as needed or direction to the most appropriate care.

• Vulnerable people living at a local hostel were visited each week by a GP who held a clinic onsite. Primary care services offered at the hostel worked well in supporting vulnerable people who were otherwise hard to reach. The GP joined up with other agencies offering support with respect to mental health and dependence on alcohol and drugs .

• The practice had recruited an Urdu speaking practice nurse to target support to South Asian diabetic patients following an identified need in this area.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 25 February 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.

• An Urdu speaking nurse had been recruited to offer targeted support to South Asian diabetic patients following an identified need within the patient population.

• 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 25 February 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 in line with local and national averages.

• 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 through our discussions with clinicians by reviewing patient records.

• 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.

• Staff had received training with respect to anti-radicalisation and terrorism awareness following a safeguarding incident.

Updated 25 February 2016

The practice is rated as good for the care of older people.

• The practice provided a named GP for patients over 75 years of age.

• They provided a range of services including working with patients to prevent unplanned admissions.

• Home visits were available to frail or housebound patients

• Several chairs in the waiting area had been provided with raised seats to assist those with mobility difficulties.

Updated 25 February 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. An example of this was the extended hours offered within the surgery and as part of the Trinity Care Group.

• 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 25 February 2016

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

• The practice regularly worked with multi-disciplinary teams in the case management of people 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 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.

• The practice followed-up patients who did not attend appointments relating to their mental health difficulties as part of learning from a significant event.A partner took a lead interest in mental health care and monitored vulnerable patients.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 25 February 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.

• A GP clinic took place in a local hostel on a weekly basis.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• Staff had received training in British Sigh Language to improve communication with patients who were hard of hearing or deaf.

• 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.