Archived: Sidings Healthcare Centre

Updated 13 June 2017

The Sidings Healthcare Centre is a newly opened purpose built building situated within the heart of the community it serves at, The Sidings, Dewsbury, WF12 9QU. The GP partners self-funded the new premises and the service relocated the main surgery in March 2016. The practice also has a branch location called Brewery Lane Surgery, which is on Brewery Lane, Thornhill Lees, Dewsbury, WF12 9DU.

Both locations provide fully accessible facilities and all services are at ground floor level: in addition the Sidings location also has a lift. Each surgery has an adjoining pharmacy. The surgeries have car parking and are accessible by bus.

The Sidings Healthcare Centre is situated within the North Kirklees Clinical Commissioning group (CCG) and provides primary medical services to 7,603 patients under the terms of a personal medical services (PMS) contract. This is a contract between general practices and NHS England for delivering services to the local community.

The National General Practice Profile shows that the age of the practice population is different to the CCG and national average with lower numbers of patients aged over 45 and higher numbers of patients aged below 39. The profile shows that 61% of the practice population is from a south Asian background with a further 1% of the population originating from black, mixed or non-white ethnic groups.

There are four GPs at the practice working the equivalent of 3.2 whole time GPs. Both GP partners are male and there are two salaried female GPs. There are three part time practice nurses, two part time health care assistants (HCA’s) and one member of staff who is training to be a HCA. The practice also has a phlebotomist who works two sessions per week and a pharmacist who works two sessions per week and is also able to provide patient consultations. The clinical team are supported by the practice manager and a team of administrative and reception staff.

The Sidings Healthcare Centre reception and surgery is open between 8am and 6.30pm Monday to Friday. The branch practice at New Brewery Lane is open between 8.30am to 1pm Monday to Friday. Extended hours appointments are offered at the New Brewery Lane location between 8am to 12pm on Saturdays for pre-bookable appointments only. All telephone calls are answered at The Sidings Healthcare Centre location.

Out of hours care is provided by Local Care Direct which is accessed by calling the surgery, patients are also advised of the NHS 111service.

Updated 13 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Sidings Healthcare Centre on 25 April 2017. Overall the practice is rated as good.

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

• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Nursing staff told us that they held a regular ‘journal club’ to review nursing articles. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• There was an open and transparent approach to safety and a system in place for reporting and recording significant events. We saw evidence that the reporting and discussion of these events had improved. The provider had identified that previously staff had not recorded low level concerns but this was now being encouraged and supported by the team.

• We reviewed 32 patient comment cards completed prior to our inspection. All of the comments received were exceptionally positive about the services provided.

• Results from the national GP patient survey (published July 2016), noted that patients had struggled to get an appointment or access their preferred GP, however the views of patients we spoke with on the day did not align with this.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• A monthly meeting was held between the lead GP for safeguarding and the Health Visitor where concerns regarding children were discussed.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff, patients and the patient participation group (PPG) which it acted on.
• The practice was positively embedded into the local community and liaised regularly with the local mosque, local leaders, community staff and the PPG. GPs at the practice would meet regularly with the Imans from the local mosques who would promote health promotion and health screening within their congregation.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider should make improvements are:

• The provider should review and consider the necessary immunisations for healthcare staff and be able to demonstrate that an effective employee immunisation programme is in place.
• The provider should review their arrangements for the identification of carers to assure themselves that they are identifying them effectively and are able to offer them the appropriate support.
• The provider should review the numbers of patients undergoing screening for cancer related illnesses and be able to assure themselves that the appropriate numbers of people are accessing these services. For example, breast, bowel and cervical screening uptake.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 13 June 2017

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

• Nursing staff had lead roles in long-term disease management and had prioritised areas such as chronic obstructive pulmonary disease and diabetes, to increase the number of patients who were invited for and attended reviews.
• The practice had identified a high number of patients with diabetes. The practice nurse had undertaken a further qualification in Insulin management which meant that a higher level of care could be offered and referrals to other services were reduced.
• Performance for diabetes related indicators for 2015/2016 was generally below Clinical commissioning Group (CCG) and national averages. For example 87% of patients on the diabetes register had a flu immunisation in the preceding August to March, compared to the CCG and England average of 95%. However, the practice were able to evidence that figures for 2016/2017 had improved, although this data had not been verified or published yet.
• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.
• There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health.
• All these patients had a named GP and there was a system to recall patients for 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 June 2017

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

• The lead GP for safeguarding met monthly with the health visitor to discuss children living in disadvantaged circumstances, including looked after children and those who were at risk, for example, children and young people who had a high number of accident and emergency (A&E) attendances.
• Childhood immunisations were not undertaken at the practice. However Immunisation rates were relatively high for all standard childhood immunisations. Data given to us by the practice for 2016/2017 showed that immunisations for 2 year olds were 98% (national average 91%) and also 98% (national average 88%) for 5 year olds in the same period. However, this data had not been verified or published yet. The practice had liaised with the local Iman and the patient participation group to encourage the uptake of vaccines.
• Patients told us, on the day of inspection, that children and young people were treated in an age appropriate way and were recognised as individuals. We saw that a teenage confidentiality policy was in place and that appointments were available outside of school hours and on a Saturday morning.
• The practice worked with midwives, health visitors and school nurses to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.
• Emergency appointments were available for babies and children.

Updated 13 June 2017

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

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.
• The practice offered proactive, personalised care to meet the needs of the older patients in its population and offered an annual health checks to patients over 75 who were not seen for other reasons.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs. Long term conditions reviews were offered in the home to patients who could not access the surgery.
• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.
• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.
• The practice participated in a CCG medicines initiative and had reviewed patients aged 75 or older who were prescribed 10 medications or more.

Updated 13 June 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these populations 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, extended opening hours and Saturday morning pre-bookable appointments.
• The practice was proactive in offering online services which included the ability to book or cancel appointments and request prescriptions. Text message reminders regarding appointments were also sent to patients.
• The practice offered in house phlebotomy (the taking of bloods for investigation), 24 hour blood pressure monitoring, spirometry and electrocardiograms (ECG). (An ECG is a simple test that can be used to check your heart's rhythm and electrical activity.)
• At their convenience, patients could use the ‘surgery pod’ at the Brewery Lane surgery for blood pressure checks and other screening services.

Updated 13 June 2017

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

• The practice carried out advance care planning for patients living with dementia.
• 97% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is better than the CCG average of 85% and the national average of 83%.
• The GP lead for mental health responded quickly to requests for visits to a residential home for adults with mental health needs registered with the practice. The service provided by the practice was described by patients as caring, person centred and first class.
• The practice had a register of all patients with mental health needs and offered annual reviews and care plans.
• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.
• Outcomes for patients with mental health needs were generally above local and national averages. For example, the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a record of their alcohol consumption in the preceding 12 months was 96% compared to the CCG average of 91% and the national average of 89%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• Patients at risk of dementia were identified and offered an assessment using a recognised assessment tool.
• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia and information was available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.

Updated 13 June 2017

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 asylum seekers and refugees, those with a learning disability and the victims of domestic violence.
• End of life care was delivered in a culturally sensitive coordinated way which took into account the needs of those whose circumstances may make them vulnerable. A bereavement information leaflet was available for families.
• The practice offered longer appointments for patients with a learning disability, patients with mental health needs and would review the needs of other patients where necessary to ensure that the appointment length met their needs.
• The practice worked closely with other health care professionals in the case management of vulnerable patients and would respond to concerns regarding individuals when they were highlighted by community leaders.
• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations and had invited a local organisation to spend time in the practice so they could signpost patients to suitable support.
• Staff interviewed 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.