Archived: Hallgate Surgery

Updated 27 July 2017

Hallgate Surgery is located on Hallgate in the centre of Cottingham and is on local bus routes. There is parking for two to three cars on the street outside the practice and there is a public car park within five minutes’ walk of the practice. The practice is in an adapted house and there is disabled access, consulting and treatment rooms are all on the ground floor. The practice provides services under a Personal Medical Services (PMS) contract with the NHS North Yorkshire and Humber Area Team to the practice population of 2478, covering patients of all ages.

The proportion of the practice population in the 65 years and over age group is above the England average. The practice population in the under 18 years age group is below the England average. The practice scored eight on the deprivation measurement scale, the deprivation scale goes from one to ten, with one being the most deprived. People living in more deprived areas tend to have greater need for health services.

In October 2016 the practice became part of Humber NHS Foundation Trust. The practice has three salaried GPs, two male, and one female, all part time. There is also a regular female locum GP. There are two practice nurses and one health care assistant (HCA), all female and all part time There is a practice manager and a team of administration, reception and secretarial staff. The practice team are supported by the Head of Primary Care

The practice is a teaching practice for medical students from the Hull York Medical School.

The practice is open between 8.30am to 6.00pm Monday to Friday; telephone lines are open from 8.00am. Appointments are available from 8.30am to 11.00am and 3.00pm to 5.20pm Monday to Friday. The practice, along with all other practices in the East Riding of Yorkshire CCG area have a contractual agreement for the Out of Hours provider to provide OOHs services from 6.00pm on weeknights. This has been agreed with the NHS England area team.

The practice has opted out of providing out of hours services (OOHs) for their patients. When the practice is closed patients use the NHS 111 service to contact the OOHs provider. Information for patients requiring urgent medical attention out of hours is available in the waiting area and in the practice information leaflet.

Updated 27 July 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hallgate Surgery on 15 June 2017. 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 a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients told us they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt 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.

There were areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Review procedures for recording medicine refrigerator temperatures so staff work within practice policy.

• Review the clinical audit programme to support the planning and completion of audit and quality monitoring cycles.

• Review intervals for mandatory refresher training.

• Improve the system for identifying carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 27 July 2017

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

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Nationally reported data for 2015/2016 showed that outcomes for patients with long term conditions were good. For example, the percentage of patients with diabetes, on the register, whose last measured total cholesterol (measured within the preceding 12 months) was 5mmol/l or less was 78%. This was comparable to the local CCG average of 81% and the England average of 80%.

• The nurses had developed an information pack for newly diagnosed diabetic patients as there was always a gap between diagnosis and patients attending the ‘Living with Diabetes’ course.

• Longer appointments and home visits were available when needed.

• Patients with LTCs had a named GP and a structured annual review to check that their health and medicines needs were being met. For those patients with the most complex needs, the named GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care.

• Practice nurses visited patients at home to do long term conditions reviews and administer flu vaccinations during the flu season.

Updated 27 July 2017

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 or who failed to attend hospital appointments.

• Immunisation rates were high for all standard childhood immunisations. Immunisation rates were comparable to or above the local CCG average. For example, rates for immunisations given to children aged 12 months, 24 months and five years in the practice were 100% for all but two of the immunisations.

• Children and young people were treated in an age-appropriate way and were recognised as individuals.

• Nationally reported data from 2015/2016 showed the practice’s uptake for the cervical screening programme was 87%. This was comparable to the local CCG average of 84% and the England average of 81%.

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

• We saw good examples of joint working with midwives, health visitors and school nurses.

  The practice monitored any non-attendance of babies and children at vaccination clinics. The practice nurses contacted the parents of children who did not attend for vaccinations and worked with the health visiting service to follow up any concerns.

Updated 27 July 2017

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. Patients over the age of 75 years had a named GP.

• The practice had assessed the older patients most at risk of unplanned admissions and had developed care plans which were regularly reviewed.

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

• The practice had worked with the CCG through an enhanced service to develop ‘The Care Home Scheme’. This ensured patients living in care homes had structured annual reviews which included a review of medication by a pharmacist, clinical care and advanced care planning and discussion of ‘Do Not Resuscitate’ decisions.

• Nationally reported data for 2015/2016 showed that outcomes were good for conditions commonly found in older people. For example, performance for heart failure indicators was 100%; compared to the local CCG average of 99% and the England average of 98%.

Updated 27 July 2017

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.

• Telephone consultations were available every day with a call back appointment arranged at a time to suit the patient, for example during their lunch break.

• 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.

Updated 27 July 2017

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• Nationally reported data from 2015/2016 showed 92% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the preceding 12 months. This was above the local CCG average and England average of 84%.

• The practice carried out advanced care planning for patients with dementia.

• Nationally reported data from 2015/2016 showed the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive care plan documented in their record in the preceding 12 months was 100%. This was above the local CCG average of 92% and the England average of 89%.

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• 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 a good understanding of how to support people with mental health needs and dementia.

• One of the GPs had a GP with Specialist Interest qualification in mental health and had experience working in a mental health and substance misuse environment until the middle of 2014.

• The practice hosted a service for the primary care substance misuse counsellor and sign posted patients requiring support with drug and/or alcohol problems to counselling and support services.

Updated 27 July 2017

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

• The practice held registers of patients living in vulnerable circumstances which included travellers and those with a learning disability.

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

• Nursing staff used easy read leaflets to assist patients with learning disabilities to understand their treatment.

• Staff had received training in travellers’ health beliefs.

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

• The practice 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, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.

• Telephone interpretation services were available.