Archived: Westgate Surgery

Updated 21 January 2016

Otley is a West Yorkshire market town with an historic reliance on agriculture. However, many workers now commute to Leeds and Bradford, but some patients remain in very rural isolated areas. The practice falls into the second least deprived decile.

Westgate surgery is located in a purpose built building. The practice operates from a single site.

The practice has a registered population size of 5845, a number that is rising by 3% a year. The demography has a slight slant to the older age group. Since 2001 the practice has been commissioned on a PMS (Primary Medical Services) contract. The practice currently has two GP partners (both male), four salaried GP’s (one male and three female), two senior practice nurses, one junior practice nurse, one health care assistant and one phlebotomist (all female). The clinical team is supported by a practice manager, and administrative team leader, two secretaries and seven receptionists.

The practice is open between 08.00am and 18.00pm Monday to Friday. Appointments are from 08.30am to 11.30am every morning and 13.30pm to 18.00pm daily. Extended hours surgeries are offered between 07.00am and 08.00am on certain pre-arranged days.

The ‘out of hours’ care is provided by Local Care Direct (LCD).

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

Updated 21 January 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Westgate Surgery on 22 July 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well-led. It was outstanding for providing services for people experiencing poor mental health. We rated the practice as good for services provided for older people, people with long term conditions, families, children and young people, working age people and people whose circumstances make them vulnerable.

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.

• 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 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 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 patient care, quality and safety as its top priority. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

We saw several areas of outstanding practice including:

• The practice was taking a lead role in the development of neighbourhood working with local practices and the third sector (Charities and not for profits organisations) to support people to stay in their own homes and receive the right health and social care according to their need.
• All staff in the practice was dementia friends and ensured the needs of people living with dementia were considered in all aspects of their care experience.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 January 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. 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.

Updated 21 January 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 extremely 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, and we saw evidence to confirm this. The premises were suitable for children and babies with a defined children area with age appropriate toys and books. We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 21 January 2016

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 and had a range of enhanced services, for example in end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 21 January 2016

The practice is rated as good for the care of working-age people (including those recently retired). 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, extended hours including early mornings as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 21 January 2016

The practice is rated as good for the care of people experiencing poor mental health. All patients experiencing poor mental health had been offered an annual physical health check. 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.

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&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

All staff in the practice were dementia friends and ensured the needs of people living with dementia were considered in all aspects of their care experience.

Updated 21 January 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 carers and those with a learning disability. It had carried out annual health checks for people with a learning disability and these patients had received a follow-up. It offered longer appointments for people with a learning disability.

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. Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing.