Archived: Morley Health Centre Surgery

Updated 23 November 2016

The practice operates from a main surgery which is located at Morley Health Centre, Corporation Street, Morley, Leeds, West Yorkshire LS27 9NB. The practice serves a patient population of around 2,400 patients and is a member of NHS Leeds West Clinical Commissioning Group.

The practice shares premises with a range of community services delivered by Leeds Community Healthcare NHS Trust. The building is situated in purpose built premises and the practice has operated from this location for around 20 years. The surgery is located on ground level and is accessible to those with a physical disability as floor surfaces are level and doorways are wide. There is parking available on the site for patients.

The practice population age profile shows that it is comparable to the England average for those over 65 years old (18% compared to the England average of 17%). Data indicates that the majority of patients are White British (86%); other significant patient ethnic groups include Asian (6%) and Eastern European (5%). The practice serves an area which is comparable with the national average with regard to deprivation.

The practice provides services under the terms of the General Medical Services (GMS) contract. This is a contract between general practices and NHS England for delivering services to the local community.

In addition the practice offers a range of enhanced local services including those in relation to:

• Childhood vaccination and immunisation

• Influenza and Pneumococcal immunisation

• Rotavirus and Shingles immunisation

• Dementia support

• Support to reduce unplanned admissions

• Improving patient online access

• Minor surgery

• Patient participation

As well as these enhanced services the practice also offers additional services such as those supporting long term conditions management including asthma, diabetes, heart disease and hypertension, travel vaccinations and joint injections.

Attached to the practice or closely working with the practice is a team of community health professionals that includes health visitors, midwives, and members of the district nursing team.

The surgery had moved from being a single-handed GP practice to a partnership in May 2015, with the partnership operating from two locations. These were at Morley Health Centre Surgery and at Kirkgate Surgery in Birstall, North Kirklees. Both these practices are currently registered with the Care Quality Commission as two separate locations.

The practice has two GP partners (one male, one female), and two regular locum GPs (one male, one female). In addition there is one practice nurse and one healthcare assistant (both female). Clinical staff are supported by a practice manager who covers both practices in the partnership, and an administration and reception team. There is an ability to move staff between the two practices according to need.

The practice appointments include:

• On the day appointments

• Pre-bookable

• Telephone consultations where patients could speak to a GP or nurse to ask advice and if identified obtain an appointment

• Home visits

Appointments can be made in person, online or via the telephone.

The practice is open between 8.30am and 6.30pm Monday to Friday with extended hours opening on a Wednesday from 6.30pm to 8pm. Additionally the practice works with other local GPs to offer appointments on a Saturday morning 8am to 12pm. These appointments were available at a nearby surgery.

Out of hours care is provided by Local Care Direct Limited and is accessed via the practice telephone number or patients can contact NHS 111.

Updated 23 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Morley Health Centre Surgery on 13 October 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 generally assessed and well managed. However, issues were identified during the inspection in relation to infection prevention and control which needed improvement.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Patients told us on the day that they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. This view was not fully supported by data from the national GP patient survey which showed mixed satisfaction in relation to consultations with GPs and nurses.
• 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. The practice had a dedicated complaints, comments and suggestions leaflet available and had developed a Patients’ Charter which highlighted services and standards that patients could expect to receive.
• Patients said they found it easy to get in contact with the practice on the telephone 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.

The areas where the provider should make improvement are:

• The practice should reinstate infection prevention and control audits at regular intervals, in line with the latest guidance

• Continue to provide regular update training for the infection prevention and control lead to enable them to fully carry out their duties in this area of work.

• Review the immunity status of staff in relation to measles, mumps, rubella and chickenpox in order to assure themselves that their staff were adequately protected in line with the latest guidance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 November 2016

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

• GPs and nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. The practice supported and reviewed patients for conditions which included coronary heart disease, asthma and diabetes. In addition to reviewing patients the clinicians developed care plans for individuals, gave healthy lifestyle advice and referred and signposted patients to other support services for their specific condition.

• The practice attended multidisciplinary team meetings with partners such as palliative care nurses, district nurses and the community matron on a monthly basis where they discussed individual patients. This facilitated the provision of joined up care and enabled all parties to be kept up to date with the care needs of the patient.

• Performance in relation to diabetes was either comparable to or better than the Clinical Commissioning Group (CCG) and national averages. For example, 97% of patients on the register had had an influenza immunisation in the preceding 1 August to 31 March which was 3% above the CCG and national average.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met.

Updated 23 November 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 relatively high for all standard childhood immunisations.

• We were told by the practice 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 practice’s uptake for the cervical screening programme was 86%, which was better than the CCG average of 79% and national average of 82%. In addition clinicians carried out regular audits with regard to cervical screening to ensure adherence to guidance and best practice.

• Appointments were available outside of school hours and the premises were suitable for children and babies. In addition children under five could access on the day appointments.

• The practice maintained close links to health visitors and community midwives who were located nearby or in the same shared premises. A weekly midwife led ante-natal clinic was held in the practice and post-natal checks were delivered by a GP and the practice nurse.

• The practice provided a range of contraception services and one of the GPs had been trained in the fitting and removal of intrauterine devices

Updated 23 November 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 appointments for those with enhanced needs.

• Receptionists offered extra help and support to patients. For example they would assist those on arrival if they needed additional support and would call taxis or carers to pick up a patient after an appointment.

• We saw evidence that at the time of inspection the practice had given flu vaccinations to 84% of its patients who were aged 65 or over.

• The practice delivered an avoiding unplanned admissions service which provided proactive care management for patients who had complex needs and were at risk of an unplanned hospital admission.

Updated 23 November 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. For example, the practice participated in the catch up programme for students aged 17 and over for measles, mumps and rubella and meningitis C vaccinations.

• The practice was proactive in offering online services; patients could book appointments and order repeat prescriptions online as well as having access to health records. The practice also offered electronic prescribing.

• The practice offered a full range of health promotion and screening that reflected the needs for this age group. As an example of this patients could be referred to alcohol support, healthy weight and smoking cessation services.

• The practice offered extended hours opening on a Wednesday evening 6.30pm to 8pm and via joint working with other practices were able to offer patients appointments on a Saturday 8am to 12pm. This latter service was delivered from a nearby surgery.

Updated 23 November 2016

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

• 100% of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive care plan documented in the record, in the preceding 12 months compared to a CCG average of 85% and a national average of 89%.

• 100% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, compared to a CCG average of 87% and a national average of 84%.

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

• Staff had a good understanding of how to support patients with mental health needs and dementia.

• Patients with mental health issues and dementia were offered regular health checks and reviews.

• Both GP partners had received training with regard to mental health capacity and deprivation of liberty safeguards (DoLS seek to give adequate protection to people who lack mental capacity to consent to care or treatment, and who need limits put on their liberty to keep them safe).

Updated 23 November 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 those with a learning disability and patients who were at risk of an admission to hospital.

• The practice offered longer appointments for patients with a learning disability and those with complex needs such as the frail elderly.

• The practice carried out alcohol screening during health checks and on the registration of new patients, this identified patients who were hazardous drinkers or had an active alcohol use disorder.The practice was then able to offer advice and support to the patient.

• The practice worked with other health care professionals in the case management of vulnerable patients.

• The practice regularly reviewed the vulnerable patients and updated care plans as necessary.

• Staff informed vulnerable patients and their carers and advocates 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.

• The practice recorded the identity of patients who had eyesight or hearing issues and used this information to offer additional support during consultations.