Leigh View Medical Practice

Updated 15 November 2016

Leigh View Medical Practice is located on Bradford Road, Tingley, Wakefield, WF3 1RQ and is a member of the NHS Leeds West Clinical Commissioning Group (CCG). Personal Medical Services (PMS) are provided under a contract with NHS England. They offer a range of enhanced services, which include:

• extended hours access
• delivering childhood, influenza and pneumococcal vaccinations
• facilitating timely diagnosis and support for people with dementia
• identification of patients with a learning disability and the offer of annual health checks
• identification of patients at a high risk of an unplanned admission and providing additional support as needed.

Leigh View Medical Practice is a purpose built premises in the suburban area of Tingley which is between Leeds and Wakefield. The premises is relatively modern, consisting of a main building with two extensions and 55 parking spaces. In addition to this space, the pharmacy next door is leased to a separate business, which offers patients convenient local access to dispensing services.

The patient list size is currently 16,529 and made up of predominantly white British patients, with a very small number of patients from mixed ethnic backgrounds. There is a slightly higher than CCG and national average number of patients aged 5 years or older. For example, 22% of the population are aged 18 or younger, compared to 19% for the CCG and 21% nationally. At 59%, there is a lower than CCG (66%) and national (61%) average number of patients who are in paid employment or full time education. However, at 2%, the unemployment status of patients is lower than CCG and national figures of 5%. In addition there are 67% of patients who have a long-standing health condition, compared to 51% CCG and 54% nationally.

There are seven GP partners (five male, two female), two male salaried GPs. There is also a regular male locum GP and four female practice nurses. The clinicians are supported by a practice manager, patient services manager, facilities co coordinator, administration co coordinator and a team of 29 others who oversee the day to day running of the practice.

The practice is open Monday to Friday 8am to 8pm, with the exception of Thursday when the practice is open from 7:30am to 7:30pm. Appointments can be pre-booked, made on the same day or a telephone consultation can be arranged. When the practice is closed out-of-hours services are provided by Local Care Direct, which can be accessed via the surgery telephone number or by calling the NHS 111 service.

Updated 15 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Leigh View Medical Practice on 12 October 2016. Overall the practice is rated as good for providing safe, effective, caring, responsive and well-led care for all of the population groups it serves.

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

• The practice complied with the requirements of the duty of candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment.)
• There was an open and transparent approach to safety. All staff were encouraged and supported to record any incidents using an electronic reporting system. There was evidence of good investigation, learning and sharing mechanisms in place.
• Risks to patients were assessed and well managed.
• There were safeguarding systems in place to protect patients and staff from abuse.
• There was a clear leadership structure; staff were aware of their roles and responsibilities and told us the GPs and practice manager were accessible and supportive. There was evidence of an all-inclusive team approach to providing services and care for patients.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients’ needs were assessed and care was planned and delivered following local and national care pathways and National Institute for Health and Care Excellence (NICE) guidance.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice staff had a good understanding of the needs of their practice population and were flexible in their service delivery to meet patient demands; such as providing additional GP appointments. As well as attending the practice for an appointment, patients could also had access to telephone consultations when required.
• Patients said they found it easy to make an appointment. There was continuity of care and if urgent care was needed patients were seen on the same day as requested.
• Information regarding the services provided by the practice and how to make a complaint was readily available for patients.
• The practice sought patient views about how improvements could be made to the service, through the use of patient surveys, the NHS Friends and Family Test and engagement with patients.
• The practice sought patient views about how improvements could be made to the service, through the use of text messages. After an appointment with the GP or Nurse the patient was sent a short text message asking to rate the service they had just received. This provided effective feedback on the clinicians, this feedback was anonymised and shared with the clinician.

• An informal incident reporting process had been introduced to encourage staff to report every occasion of spotting anything going wrong. These forms called “ Oops Something has gone a bit wrong” were ways of flagging up patterns. To counter balance the potential negatives of identifying problems, the practice had also introduced a similar form called “What about if”” to encourage staff to share their ideas for improvements to the practice. These forms effectively encouraged ‘Incident Reporting’ and involvement of the whole practice team in improving the service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 15 November 2016

The practice is rated as good for the care of people with long term conditions.

• The GPs and practice nurse both supported the management of long term conditions. Annual or six monthly reviews were undertaken to check patients’ health care and treatment needs were being met. The practice had an effective system to follow up those patients who did not attend the practice for their review.
• The practice maintained a register of patients who were at high risk of an unplanned hospital admission. Care plans and support were in place for these patients.
• Clinicians liaised with the community matron regarding care, treatment and support of these patients, particularly those which were housebound.
• There were effective systems in place to support the recall of these patients for influenza and pneumococcal vaccinations.
• Pre-diabetes checks were undertaken with those patients who were deemed most at risk of developing diabetes.
• 93% of patients with diabetes, on the register, who have had influenza immunisation in the preceding 12 months (CCG and national averages 94%).
• 76% of patients diagnosed with asthma had received an asthma review in the last 12 months (CCG and national averages of 75%).
• 96% of patients diagnosed with chronic obstructive pulmonary disease (COPD) had received a review in the last 12 months (CCG average 89%, national average 90%).
• The practice had developed a call/recall system for long term conditions. This aimed to ensure that patients could get all the checks they needed in a single appointment with a health care assistant prior to their review by being invited to attend during the month of their birthday.
• The practice had also supported the patient education and support group in setting up a peer led diabetes support group in partnership with Diabetes UK. The patient education and support group is an element of the patient involvement group.

Updated 15 November 2016

The practice is rated as good for the care of families, children and young people.

• The practice worked with midwives, health visitors and school nurses to support the needs of this population group. For example, the practice hosted ante-natal, post-natal and child health surveillance clinics.
• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk.
• Patients and staff told us 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. Same day access was available for all children under the age of five.
• At between 95% and 100%, immunisation uptake rates were in line with CCG and national rates for all standard childhood immunisations. There was a dedicated member of staff who followed up those children and their families who did not attend or who were overdue for immunisations.
• Sexual health, contraceptive and cervical screening services were provided at the practice, which included coil fitting, implants and chlamydia screening.
• The practice promoted cervical screening and 80% of eligible patients had received a test (CCG average 79%, national average 82%).
• Routine access for appointments is usually within five days, often 48 hours, and all staff were aware that young children’s conditions may change rapidly. The practice have on-the-day access for patients under five years, and staff are enabled to add or hasten appointments, and bring to a clinician’s attention any patient in distress.

Updated 15 November 2016

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

• Proactive, responsive care was provided to meet the needs of the older people in its population.
• They offered rapid access appointments to those patients with enhanced needs and those who could not access the surgery due to ill health or frailty.
• Medication reviews were completed annually.
• Registers of patients who were aged 75 and above and also the frail elderly were in place to ensure timely care and support was provided.
• The practice worked closely with other health and social care professionals, such as the district nursing team, to ensure housebound patients received the care and support they needed.
• The practice held flu clinics to ensure eligible patients received their vaccination. During our inspection we saw this was a well-managed and effective system providing vaccinations to over 150 patients. After the inspection we were sent a report (14 October 2016) which showed that 59 positive patient responses were recorded. Comments included ‘brilliant’, ‘excellent’ and ‘1st class service’.
• The practice offered housebound patients home visits by the Health Care Assistants and Nursing Team for chronic disease reviews.
• The patient club, which is a branch of patient involvement group that the practice had set up, arranged activities for patients at the practice. Chair aerobics, coffee mornings, arts and crafts afternoons and meals were arranged and these events were made openly available for all patients to attend, if they so wished.
• The Practice offered shingles and pneumonia vaccinations as well as influenza for patients aged 65 and over. Patients up to the age of 74 were able to receive an NHS Health Check at the practice.

Updated 15 November 2016

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these patients 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 provided extended hours appointments on evenings, telephone consultations, online booking of appointments and ordering of prescriptions.
• The practice offered a range of health promotion and screening that reflected the needs for this age group.
• Travel health advice and NHS travel vaccinations were available.
• The practice operated from 8am to 8pm every week day, with the exception of Thursdays when the practice opened from 7:30am to 7:30pm.
• The practice used their website and social media as platforms to share information with their patients.
• The practice is signed up to the CCG enhanced access scheme which provides access to appointments with a range of health care professionals 12 hours a day every weekday. This is designed to increase access to routine care (including management of long term conditions) for people of working age. At the time of our inspection the practice were involved in plans to open a ‘hub’ in Morley to provide routine general practice across the weekend for patients in the ‘Morley and District’ locality. This service would be provided by Leeds West Primary Care Ltd (a network of GP practices across the CCG).
• The practice is proactive in inviting eligible people for NHS Health Checks.

Updated 15 November 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 multidisciplinary teams in the case management of people in this population group, for example the local mental health team.
• Patients and/or their carer were given information on how to access various support groups and voluntary organisations.
• 95% of patients diagnosed with dementia and 92% of patients who had a complex mental health problem, such as schizophrenia, bipolar affective disorder and other psychoses, had received a review of their care in the preceding 12 months. These were both slightly above CCG and national averages.
• The practice followed up patients who did not attend their appointments.
• Patients who were at risk of developing dementia were screened and support provided as necessary.
• Staff had a good understanding of how to support patients with mental health needs or dementia.

Updated 15 November 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• Staff knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.
• We saw there was information available on how patients could access various local support groups and voluntary organisations.
• An alert was placed on the electronic record of patients who had a learning disability, to raise awareness with staff of any potential vulnerability.
• There was a designated member of staff who managed a register of patients who had a learning disability and ensured they were offered an appointment for an annual health review.