Archived: Ferrybridge Medical Centre

Updated 19 November 2015

Ferrybridge Medical Centre is situated within a purpose built surgery in Knottingly, Wakefield known as Beauforth House. Beauforth House has a separate building, known as the High Street, where additional surgery space can be utilised for clinics as required. This building is situated a short distance across from Beauforth House car park. We visited both buildings during this inspection. There is also a branch surgery at The Surgery, Anne Sharpe Centre, St Edwards Close, Byram, WF11 9NT. We visited this branch surgery as part of this inspection.

The practice provides Personal Medical Services (PMS) for 9,911 patients across the three sites in the NHS Wakefield Clinical Commissioning Group (CCG) area.

There are five GP partners, and four salaried GPs, four advanced nurse practitioners, one specialist practitioner nurse, two practice nurses and three health care assistants who all work across both sites. There is a large administration team who also work across each site including a practice manager, reception manger and IT manager. The practice manager is responsible for all three sites.

The practice is open at the following times across the three sites:

• Beauforth House - Reception opening times are 8am to 6.30pm Monday to Friday. Surgeries are between 8.30am and 6.30pm Monday to Friday.
• High Street – Reception opening times are 8am to 6.30pm, Monday to Friday.This building holds surgeries and clinics between 8.30am and 6pm Monday to Friday as required and provides additional space to Beauforth House.
• Byram – Reception opening times are 8.15am to 11.30am and 2.30pm to 6.30pm Monday to Friday. Surgery opening times are from 8.30am to 11.30am and 2.30pm to 6.30pm Monday to Friday excluding Wednesdays. On Wednesdays, Byram closes at 11.30 am.

Extended Hours are provided 8.30am to 11.30am every Saturday at Beauforth House. Walk-in blood test clinics are available at the High Street building every Monday 1.30pm to 4.15pm, Tuesday 8am to 11.30am and Thursday 8am to 11.30am.

Longer appointments are available for those who need them and home visits and telephone consultations are available as required.

The practice provides a dispensing service to 2,700 of its patients from both Beauforth House and Byram surgeries.

Out of hours services are provided by Local Care Direct. Calls are diverted to this service when the practice is closed.

The practice also provided training in general practice for doctors and medical and nursing students.

The practice is registered to provide the following regulated activities; maternity and midwifery services; surgical procedures, family planning, diagnostic and screening procedures and treatment of disease, disorder or injury.

Updated 19 November 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Ferrybridge Medical Centre on 8 September 2015. Overall the practice is rated as outstanding.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, the practice had identified a gap in the sexual health service in the area and they had commenced a weekly youth clinic for patients under the age of 18 years.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided in a number of formats to help patients understand the care available to them.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet people’s needs. The practice had pioneered GP and advanced nurse practitioner (ANP) appointments at Pontefract General Infirmary to improve access for patients at weekends and to reduce the burden on the local accident and emergency department.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the Patient Participation Group (PPG).
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Information about how to complain was available and easy to understand
• The practice had a clear vision which had quality and safety as its top priority. A business plan was in place, was monitored and regularly reviewed and discussed with all staff. High standards were promoted and owned by all practice staff with evidence of excellent team working across all roles.

We saw several areas of outstanding practice including:

• The practice had shared the outcomes of a clinical audit undertaken within the practice relating to guidance published by the National Institute for Health and Care Excellence (NICE). They had shared the outcomes internally, locally with the Clinical Commissioning Group and nationally in a published paper in the British Journal of General Practice in September 2015.
• The practice had identified a gap in the sexual health service in the area. An advanced nurse practitioner (ANP) had been recruited to improve access to advice and support, particularly for young people. The nurse had worked with the Terence Higgins Trust to commence a weekly youth clinic for patients under the age of 18 years.
• The practice offered separate advice lines for children and those with long term conditions during opening hours. These were staffed by the ANPs. This enabled patients to access clinical support and advice and where necessary and appropriate be prescribed medicines. Patients said they found this to be a very useful service.
• The practice worked with the local Clinical Commissioning Group (CCG) to improve access to services at weekends. They had pioneered GP and advanced nurse practitioner appointments at Pontefract General Infirmary (A common venue where patients go to the accident and emergency department). They had written the business case, managed the pilot and assumed information governance responsibility. GPs and ANPs from the practice had filled the rota for these clinics. This scheme had been launched in February 2015 and had been extended until end of September 2015.

However there were areas of practice where the provider should make improvements:

• Improvements should be made in the dispensary at the branch surgery in relation to security and receipt of waste medicines. Dispensary staff should be involved in root cause analysis where there are significant events or near misses in their area.
• The High Street building should have more immediate access to a defibrillator.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 November 2015

The practice is rated as outstanding 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. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

The practice operated an advice line for patients and access to week end appointments at the local hospital.

Flu vaccination rates were one of the highest in the area. The majority of patients with three or more long term conditions had a care plan.

There were robust recall systems in place managed by dedicated clinical and non-clinical staff for each area. The practice held specific clinics for patients with more than one long term condition so they only had to attend once for their reviews. A walk-in blood test clinic was provided three times per week.

Clinical audits were used to improve the outcomes for patients with long term conditions. Outcomes of audits had been widely shared both locally and nationally.

Updated 19 November 2015

The practice is rated as outstanding 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. The advanced nurse practitioner with the lead role for safeguarding worked closely with the health visitor and other agencies. Childhood immunisation rates for the vaccinations given were higher than local CCG averages. The practice had worked well with the local travelling community and had provided an immunisation programme for children living in these circumstances within their own environment. 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. Appointments were available outside of school hours and the premises were suitable for children and babies.

The practice had identified a gap in the sexual health service in the area and services had been developed to improve access to advice and support, particularly for young people.

There were a number of positive comments about the care and treatment of children in respect of access to urgent appointments and the caring attitude of reception and clinical staff. The practice had developed a telephone advice line for parents giving them quick and easy access to clinical support during practice opening hours.

Updated 19 November 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. The practice provided weekly GP and advanced nurse practitioner visits to a local care home.

The practice operated an advice line for patients and access to week end appointments at the local hospital.

Flu vaccination rates were one of the highest in the area.

Updated 19 November 2015

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

The appointment system was flexible and provided extended hours and walk-in blood test clinics. A telephone advice line was also provided which gave patients quick and easy access to clinical advice and support.

Updated 19 November 2015

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. It carried out advance care planning for patients with dementia. Performance for mental health related indicators was 100% which was 5.8 percentage points above CCG average and 9.6 percentage points above England average.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. It had a system in place to follow up patients who had attended accident and emergency (A and E) where they may have been experiencing poor mental health.

Updated 19 November 2015

The practice is rated as outstanding 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 had three nurse clinical leads and a dedicated administration person for learning disability patients. Annual health reviews were completed for these patients and care and treatment could be provided in the patient’s own home where this was beneficial and assisted in engaging patients to have appropriate care. Ferrybridge surgeries were accredited as a “Safer Place” which is a scheme to provide a safe haven for vulnerable patients lost in the community. The practice had worked well with the local travelling community and had provided an immunisation programme for children living in these circumstances within their own environment. The practice provided in house services to provide care and treatment for patients with misuse of drug and alcohol related needs.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told vulnerable patients about how to access various support groups and voluntary organisations. There were robust systems in place to safeguard children and adults whose circumstances may make them vulnerable. 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.