Kirkburton Health Centre

Updated 5 May 2016

Kirkburton Health Centre and is part of Greater Huddersfield Clinical Commissioning Group (CCG). It is located within a rural area on the outskirts of Huddersfield in a purpose built health centre. There is disabled access, all patient areas are on one level and there are car parking facilities on site.

The practice has a patient list size of 8,072 with a higher than national average of patients aged between 40 to 70 years. The majority of patients are white British and there are low levels of deprivation in the practice area. The practice provides care and support to patients who have severe mental health problems and who are resident in a local care home.

There are four GP partners, two male and two female, and two salaried female GPs. The clinical team also consists of three practice nurses and two health care assistants; all of whom are female. The clinicians are supported by a practice manager and a team of administration and reception staff.

The practice is open between 8am to 6pm Monday to Friday, with extended hours from 7.30am Monday, 7am Friday and until 8pm on Thursday. Telephone consultations were sometimes held by clinicians, dependent on the need of the patient. The practice also provides an emergency clinic between 11am and 11.30am each week day, where appointments are made by telephoning the practice on the day.

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.

Personal Medical Services (PMS) are provided under a contract with NHS England. The practice is registered to provide the following regulated activities; maternity and midwifery services, family planning, diagnostic and screening procedures and treatment of disease, disorder or injury. They also offer a range of enhanced services such as influenza, pneumococcal and childhood immunisations.

The practice has good working relationships with local health, social and third sector services to support provision of care for its patients. (The third sector includes a very diverse range of organisations including voluntary, community, tenants’ and residents’ groups.)

Kirkburton Health Centre is a teaching and training practice. They are accredited to train qualified doctors to become GPs and to support undergraduate medical students, with clinical practice and theory teaching sessions.

Updated 5 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Kirkburton Health Centre on 24 November 2015. Overall the practice is rated as good.

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

• Risks to patients were assessed and well managed. There were good governance arrangements and appropriate policies in place.
• The practice was aware of and 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 a culture of openness and honesty, which was reflected in the approach to safety. All staff were encouraged and supported to record any incidents using the electronic reporting system. There was evidence of good investigation, learning and sharing mechanisms in place.
• There was a clear leadership structure, staff were aware of their roles and responsibilities and told us the GPs and manager were accessible and supportive.
• Patients’ needs were assessed and care was planned and delivered following best practice 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 were involved in care and decisions about their treatment.
• Patients said they found it easy to make an appointment, there was continuity of care and urgent appointments were available on the same day as requested.
• Longer appointments were given to those patients who needed them.
• Information regarding the services provided by the practice was available for patients.
• The practice had good facilities and was well equipped to treat and meet the needs of patients.
• There was a complaints policy and clear information available for patients who wished to make a complaint.
• The practice sought patient views how improvements could be made to the service, through the use of patient surveys, the NHS Friends and Family Test and the patient participation group.

We saw an area of outstanding practice:

• The practice facilitated a young peoples’ health clinic once a week at Kirkburton Health Centre. The clinic was accessible for any young people, including under 16’s, who lived locally and who were not necessarily registered with the practice. Advice and support were provided regarding sexual health, domestic violence issues, substance misuse and bullying.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 5 May 2016

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

• All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. The practice nurses had lead roles in the management of long term conditions
• Patients who were identified most at risk of hospital admission were identified as a priority.

• 91% of newly diagnosed diabetic patients had been referred to a structured education programme in the last 12 months, compared to 90% locally and nationally.
• 83% of patients diagnosed with asthma had received a review in the last 12 months, compared to 78% locally and 75% nationally.
• 92% of patients diagnosed with chronic obstructive pulmonary disease (COPD) had received a review in the last 12 months, compared to 92% locally and 90% nationally.
• Longer appointments and home visits were available when needed.
• The practice facilitated a community anticoagulant (INR) clinic for patients who were taking warfarin and other anticoagulants.

Updated 5 May 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 accident and emergency (A&E) attendances.
• 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. All children who required an urgent appointment were seen on the same day as requested.

• The practice worked with midwives, health visitors and school nurses to support the needs of this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.
• Immunisation uptake rates were high for all standard childhood immunisations, with an achievement of 100% for many vaccinations.
• Sexual health, contraceptive and cervical screening services were provided at the practice.
• 87% of eligible patients had received cervical screening, compared to 86% locally and 82% nationally.

• Appointments were available with both male and female GPs.

Updated 5 May 2016

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

• The practice provided proactive, responsive and person centred care to meet the needs of the older people in its population. Home visits and urgent appointments were available for those patients in need.
• 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.
• Care plans were in place for those patients who were considered to have a high risk of an unplanned hospital admission

Updated 5 May 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.

• Telephone consultations were available.
• 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.
• Health checks were offered to patients aged between 40 and 74 who had not seen a GP in the last three years.
• The practice offered various extended hours appointments three days per week.
• The practice facilitated a young peoples’ health clinic once a week at Kirkburton Health Centre. The clinic was accessible for any young people, including under 16’s, who lived locally and who were not necessarily registered with the practice. Advice and support was provided regarding sexual health, domestic violence issues, substance misuse and bullying.

Updated 5 May 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.
• There were in-house counselling services provided by the Improving Access to Psychological Therapies (IAPT) team on a weekly basis.
• 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.
• Staff had received dementia friendly training and had a good understanding of how to support patients with mental health needs and dementia.
• Advance care planning was undertaken with patients who had dementia, 84% of who had received a face to face review of their care in the last 12 months, which was comparable to the local and national averages.
• The practice provided care and support to patients who had severe mental health problems and who were resident in a local care home.
• 81% of patients who had a complex mental health problem, such as schizophrenia, bipolar affective disorder and other psychoses had received an annual review in the past 12 months and had a comprehensive, agreed care plan documented in their record. This was below both the local and national averages of 90% and 88% respectively.

Updated 5 May 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 and regularly worked with multidisciplinary teams in the case management of this population group.
• 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.
• Information was provided on how to access various local support groups and voluntary organisations.
• Longer appointments were available for patients as needed.
• The practice was in the process of developing a template for undertaking annual health reviews of patients with Down’s Syndrome.