Archived: Orchard 2000 Group - Bransholme

Updated 13 May 2016

Orchard 2000 Group - Bransholme is located in the north of the city of Hull in the Bransholme area and provides services under a General Medical Services (GMS) contract with NHS England, Hull Area Team. The practice population is 3,214 covering patients of all ages. The practice is located in a modern purpose built building that houses other primary healthcare providers. The building is accessible by public transport links. There is designated free parking for the practice. The building has disabled access and facilities including a lift. There is an induction loop for people that are hard of hearing.

The practice offers appointments bookable four weeks in advance as well as appointments on the day between 9:00am and 6:00pm. Walk in patients will also be seen in urgent cases.

Patients can access appointment booking and ordering repeat prescriptions online through the practice website.

The practice is one of two practices in Hull run by the partners under the Orchard 2000 Group. These two practices are registered as separate locations. Staff are shared across both sites as and when needed. The two partners were mainly based at a site each.

The practice had recently been taken over from a previous GP who retired in September 2015. There new partner worked alongside the retiring GP since October 2013 until the handover.

There are two partners at the practice, both male. There is a salaried female GP. There is an advanced nurse practitioner, three part time practice nurses and a phlebotomist. There is a practice manager, two senior administrative assistants, four receptionists, one secretary and an apprentice.

The practice manager was new in post in December 2015.

The practice is open between is open Monday to Friday between 8am and 6.30pm. The practice, along with all other practices in the Hull CCG area have a contractual agreement for NHS 111 service to provide Out of Hours (OOHs) services from 6.30pm. This has been agreed with the NHS England area team.

The practice scored one on the deprivation measurement scale, which is the most deprived. People living in more deprived areas tend to have greater need for health services. The overall practice deprivation score is higher than the England average, the practice is 48.6 and the national average is 21.8.

Updated 13 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Orchard 2000 Group - Bransholme on 25 February 2016. Overall 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 an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based 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 they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that 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 patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 13 May 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.

• Nationally reported data for 2014/2015 showed that outcomes for patients with long term conditions were generally good.

• Longer appointments and home visits were available when needed.

• Appointments could be arranged to take place in people’s homes or by telephone.

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

Updated 13 May 2016

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

• Children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• 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 relatively high for all standard childhood immunisations.

• Nationally reported data from 2014/2015 showed patients diagnosed with asthma, on the register, who had an asthma review in the last 12 months was 99.2%, which was 23.4% above the local CCG average and 23.9% above the national average

• Nationally reported data from 2014/2015 showed the practice’s uptake for the cervical screening programme was 90.9%, which was 9.1% above the local CCG average and 9.1% above the national average.

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

• All children under five were prioritised and offered same day appointments. After school appointments were available.

• There was a safeguarding policy and procedure for children and young people and all staff were trained to Safeguarding level 2, with the GPs trained to Safeguarding level 3.

Updated 13 May 2016

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.

• The practice was responsive to the needs of older people, and offered home visits and urgent and longer appointments for those with enhanced needs.

• Telephone appointments were available to older people as well as advice over the telephone when a face to face appointment was not necessary.

• The practice worked closely with the community nursing teams, social services, carer’s association and the medicines management team.

• The practice maintained a carer’s register and consent to medical information to help family members and carers to access medical information if necessary.

Updated 13 May 2016

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.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

• Advice on healthy lifestyles such as diet, smoking, exercise and alcohol was given and any appropriate referrals made.

Updated 13 May 2016

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

• Nationally reported data from 2014/2015 showed 100% of people diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months. This was 14.5% above the local CCG average and 16% above the national average.  

• Nationally reported data from 2014/2015 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 11.8% above the local CCG average and 11.7% above the national average.

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

• The practice carried out 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.

• 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 patients with mental health needs and dementia.

• Information about mental health was available in the waiting area.

Updated 13 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 including homeless people, travellers and those with a learning disability.

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

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

• The practice informed 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.