Dr R Gupta & Dr H Parikh Also known as Newland Surgery

Updated 10 March 2016

Newland Surgery is a modern and accessible purpose built practice serving a patient list of 3750 and is situated in an ex-mining area in the Wakefield district. Whilst the practice has extended boundaries, patients mainly live in a number of local villages. The population are mainly White British, with a black and minority ethnic (BME) population of 6%. There are average levels of deprivation experienced locally and a slightly above average number of elderly patients. There are eight patients registered in local care homes.

The practice is managed by two partners; Dr Ram Gupta and Dr Hemal Parikh (both male). They are supported by a part time female locum. There are two female practice nurses, a female health care assistant and a practice manager. The practice has a small reception and administrative team.

The practice delivers care through a Primary Medical Services contract and is open Monday to Friday 8am-6.30pm. Appointments are offered throughout the day, except Thursday afternoon and there are extended hours on a Monday evening for prebooked appointments between 6.30-8.30pm. Out of hours care is provided by Local Care Direct.

Updated 10 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Newland Surgery on 23 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 analysing significant events. Learning from significant events was owned and shared amongst the whole practice team.
• Risks to patients 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.
• The practice team was committed to providing high quality care and they fostered collaborative and respectful team working with each other and with external agencies to promote good patient outcomes.
• Patients said they were treated with compassion, dignity and respect and were involved in their care and decisions about treatment. This was reflected in consistently higher than average patient survey results.
• Information about services and how to complain was available and easy to understand.
• Patients told us they were able to make an appointment with a named GP and this was confirmed when we saw records that reflected that there was continuity of care. Urgent appointments were available the same day for patients considered vulnerable and within 48 hours for other patients unless a same day appointment was clinically indicated. Telephone consultations were also available.
• The practice had good facilities and was well equipped to treat patients and meet their needs. These included facilities for disabled people including an adapted reception area and interpretation services.
• There was a clear leadership structure and staff felt very 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; a legal duty to be open and truthful if harm has been caused to a patient.

We saw several areas of outstanding practice:

• The practice hosted a regular hospital consultant led diabetes clinic for patients. This encouraged the sharing of expertise across the clinical team and also improved patient outcomes in this priority area for the practice.

• The practice had a number of health information leaflets in various community languages that promoted health awareness in this population group.

• A health trainer was regularly available on the premises to help patients set health improvement goals in areas such as weight management and alcohol consumption. Smoking cessation advice was also available.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 10 March 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.

• A hospital consultant led diabetes clinic was offered regularly at the practice which offered care closer to home, reduced journey times for patients and shared expertise across the clinical team.

• Joint injections could be offered as required at the surgery for patients.

• 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 10 March 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 broadly in-line with local and national averages for all standard childhood immunisations.

• Staff told us that children and young people were treated in an age-appropriate way and were recognised as individuals. We saw evidence to confirm this as clinicians were able to demonstrate their awareness of and commitment to relevant guidelines relating to the treatment of children and consent.

• The practice participated in a national initiative to give free and discreet access to contraception for young people.

• There were discreet testing packs for chlamydia (a sexually transmitted infection) available in the toilets for people to collect and return. Chlamydia affects all age groups, but is particularly prevalent in young people.

• Rates of cervical screening for eligible women were in line with local and national averages.

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

Updated 10 March 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.

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

• Patients at risk of an unplanned hospital admission were identified and followed up by the practice nurse who had protected time to undertake this activity.

• Patients over 75 years had a named GP and the practice were aware of services that could benefit older people like Age UK and carers support, signposting patients accordingly.

Updated 10 March 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.

• There was an extended hours surgery on a Monday evening for those that struggled to attend the practice during normal working hours, with telephone consultations available and encouraged to enable access to both GPs and the nursing team.

• The practice had recently arranged for local ultrasound services to be offered within the practice. This gave opportunities for a variety of diagnostic procedures, with abdominal aortic aneurysm (AAA) monitoring also available. AAA checks for an abnormality in the main blood vessel of the body, and is a test usually offered to men from the age of 60.

• A health trainer visited the practice on a regular basis to help patients set goals in improving their health and well-being.

• The practice was proactive in offering online services, although initial take-up had been slow, as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 10 March 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 worked in partnership with a local provider to support patients taking benzodiazepines (drugs used to treat anxiety or depression) to address their underlying difficulties and aim to reduce their reliance on this medication. This followed a local review that found that the practice were prescribing at a higher rate than other surgeries in the locality.

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

Updated 10 March 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 people with addiction problems and those with a learning disability.

• Frail or housebound patients were visited at home and offered an annual flu vaccination.

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

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

• 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.