Archived: Shafton Lane Surgery

Updated 17 March 2016

Shafton Lane Surgery is situated in Holbeck to the south east of Leeds and is part of the Leeds South and East Clinical Commissioning Group (CCG). The practice is located in a purpose built, leased building in one of the most deprived areas of Leeds. It has a patient list size of 2,905 with a higher than national average of patients aged between 20 and 45. Fifty four per cent of patients have a health related problems in daily life, compared to 49% nationally. There is a higher than average unemployment rate of 17%, compared to 6% nationally.

The practice is open Monday to Friday 8am to 6pm with extended hours on Monday from 6pm to 7.30pm. Appointment times with the GP are:

Monday 9.30am to 12.20pm and 2.30pm to 8pm (there is an open access clinic between 3pm to 4pm)

Tuesday and Wednesday 9.30am to 12.30pm and 2.30pm to 5.20pm

Thursday and Friday 8.30am to 10.30am and 2.30pm to 5.20pm

Saturday morning appointments are available from November 2015 to March 2016 under the Winter Pressure Scheme.

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.

There is one female GP, who is supported by a regular male locum GP. The practice is also staffed by one female practice nurse, a female health care assistant, a practice manager, an assistant practice manager and a team of experienced administration and reception staff. One of the practice nurses had recently retired from the practice and a replacement was being sought.

General Medical Services (GMS) are provided under a contract with NHS England. Shafton Lane Surgery is registered to provide the following regulated activities; maternity and midwifery services, diagnostic and screening procedures, treatment of disease, disorder or injury and surgical procedures. They also offer a range of enhanced services such as influenza, pneumococcal and childhood immunisations.

We were informed the practice had been in negotiations with an alternative provider to take over the contract. This had not been successful and the practice were currently in discussions with both NHS England and Leeds South and East Clinical Commissioning Group to discuss future developments.

A previous CQC inspection had been undertaken at Shafton Lane Surgery on 21 October 2014, they had then been found to be requiring improvement for safe, with an overall rating of good.

Updated 17 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Shafton Lane Surgery on 9 February 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:

• There was an open and transparent approach to safety and an effective system was in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• 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 we spoke with and comments we received were positive about access to the service. They said they found it easy to make an appointment and urgent appointments were available on the same day as requested.
• The practice had good facilities and was well equipped to treat and meet the needs of patients.
• The practice sought patient views on 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.
• Information about services and how to complain was available and easy to understand.
• There was a clear leadership structure and staff were supported by management.
• The provider was aware of and complied with the requirements of the Duty of Candour.

However, there was one area of practice where the provider should make improvements:

• Maintain a formal risk register of those patients who are most at risk of having an unplanned hospital admission. This would enable the practice to ensure they are providing additional care and support for all those patients as appropriate.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 17 March 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 medicines needs were being met. The practice nurses had lead roles in the management of long term conditions and patients at a high risk of hospital admission were identified as a priority.
• Longer appointments and home visits were available when needed.
• The practice delivered care for all patients who had a diagnosis of diabetes using an approach called The House of Care. This approach enabled patients to have a more active part in determining their own care and support needs in partnership with clinicians.

• 74% of patients diagnosed with asthma had received a review in the last 12 months, compared to 75% locally and nationally.
• 95% of patients diagnosed with chronic obstructive pulmonary disease (a lung disease) had received a review in the last 12 months, compared to 88% locally and 90% nationally.
• Patients who required palliative care were provided with support and care as needed, in conjunction with other health care professionals.

Updated 17 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 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 the provision of ante-natal, post-natal and child health surveillance clinics.
• Uptake rates were comparable to local practices for all standard childhood immunisations.
• Sexual health advice, contraceptive and cervical screening services were provided at the practice.
• 75% of eligible patients had received cervical screening, compared to 82% both locally and nationally. The practice proactively encouraged eligible women to attend for screening.

Updated 17 March 2016

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

• The practice provided proactive, responsive and personalised care to meet the needs of the older people in its population. Home visits and urgent appointments were available for those patients with enhanced needs.
• The practice worked closely with other health and social care professionals, such as the district nursing team, to ensure housebound patients received the care they needed.
• Health checks were offered for all patients over the age of 75 who had not seen a clinician in the previous 12 months.
• The practice could identify those patients who were most at need of care and support.

Updated 17 March 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.
• Saturday morning clinics were available during the Winter Pressure Scheme from November 2015 until the end of March 2016.
• 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. For example, cervical screening and early detection of chronic obstructive pulmonary disease for patients aged 35 or above who were either a smoker or ex-smoker. Health checks were offered for patients aged between 40 and 75 who had not seen a GP in the last three years.

Updated 17 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 multidisciplinary teams, such as the local mental health team, in the case management of people in this population group. Patients and/or their carer were given information on how to access various support groups and voluntary organisations, such as Carers Leeds.
• All patients diagnosed with dementia had received a face to face review of their care in the last 12 months, which was higher than the local and national averages
• All patients who had a severe mental health problem had received an annual review in the past 12 months and had a comprehensive, agreed care plan documented in their record. This was higher than both the local and national average of 88%.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 17 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 and regularly worked with multidisciplinary teams in the case management of this population group.
• Information was provided to patients on how to access various local support groups and voluntary organisations.
• Longer appointments were available for patients as needed.
• 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.
• There were in-house counselling services available for patients who may have alcohol misuse issues.
• Screening for HIV, Hepatitis B and C was provided for patients as appropriate.
• The practice had good links with a local ex-prisoner rehabilitation centre.