Archived: Dr Michael Pacynko Also known as Michael K Pacynko

Updated 24 September 2015

Dr Pacynko (also known as Meltham Village) is a small practice situated in the centre of Meltham Village, a semi-rural area on the edge of the Peak District and between the small towns of Holmfirth and Slaithwaite. At the time of our inspection there were 2534 patients on the practice list. We were told the practice is due to become a branch of Elmwood health centre which is located in Holmfirth.

The practice has a PMS (Personal Medical Services) contract and offers enhanced services; for example, various immunisation checks. It also offered and deliver alcohol interventions to patients seeking to reduce alcohol related health risks.

The practice has one male GP and one locum female GP. In addition, there is one female practice nurse and a female healthcare assistant. The clinical team are supported by an office manager/receptionist and a team of experienced administration and reception staff. They also receive additional support from a practice manager at Elmwood Health Centre. The practice is open Monday to Friday 8.00am to 6pm. Appointment times are Monday to Friday 8.30 to 5.00, with the exception on Thursdays when appointments start at 9.00. Extended surgery appointments are available on Wednesdays to 8.00pm. When the practice is closed, out of hours cover for emergencies is provided by Local Care Direct.

Updated 24 September 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Pacynko (Meltham Village Surgery) on 6 August 2015. Overall the practice is rated as good.

Specifically we rated the practice as good in providing effective, caring, responsive and well-led services. However, it was rated as requires improvement for providing safe services. It was rated as good for providing services for all of the population groups.

Our key findings were as follows:

• Patients said they found it easy to make an appointment with the GP, there was continuity of care and urgent appointments were available the same day.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• There was a leadership structure and staff felt supported by the GP. The practice proactively sought feedback from staff and patients.
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded and addressed.
• Feedback from patients about their care and treatment was consistently and strongly positive. Patients were truly respected and valued as individuals. The practice showed a commitment to being compassionate and caring to all population groups.

However, there were areas of practice where the provider needs to make improvements.

Importantly, the provider should:

• Ensure fire risk assessments and fire drills are undertaken.
• Ensure all policies and procedures reflect current practice, such as business continuity, safeguarding and clinical governance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 September 2015

The practice is rated as good for the care of people with long term conditions. The practice identified patients who needed additional support with an electronic alert system. Regular health checks were offered to patients for the early detection and prevention of diseases, such as cardiovascular.

The practice had a cancer and palliative care register which were regularly monitored and discussed at clinical meetings. Patients with long term conditions were supported by the GP, nurse and healthcare assistant. Home visits were GP led for the purpose of continued monitoring, observation and follow up based on physical and social need. Home visits could be requested by patients’ carers, including patients in residential or nursing homes. Staff worked with relevant health and social care professionals to deliver a multidisciplinary package of care. Reviews to check health and medication needs were available. Carers, advocates or case workers were invited to attend with patients on their appointments to provide additional support.

Updated 24 September 2015

The practice is rated as good for the care of families, children and young people. Appropriate channels of communication with relevant agencies were used to safeguard children. Clinical cases were discussed at multi-disciplinary meetings. The practice had a system in place to identify patients at risk. The practice provided antenatal services and childhood immunisations. Post-natal home visits were also offered to patients on the register. These visits were used as an opportunity to discuss immunisations and post-natal checks. Mothers, babies and young children had a six to eight week check with the health visitor and meetings were held with the health visiting team at least fortnightly to discuss any concerns. Appointments were available outside of school hours and the premises were suitable for children and babies. The practice told us all young children were prioritised and same day urgent appointments were available.

Updated 24 September 2015

The practice is rated as good for the care of older people. The practice told us they were in the process of developing a carer’s register. They also had a carer’s champion.

Nationally reported data showed outcomes for patients were good for conditions commonly found in older people. The practice was responsive to the needs of older people, offering home visits and longer appointments. The practice worked closely with other health care professionals to ensure housebound patients received the care they needed. The practice also provided services for approximately 20 patients who resided in local nursing and care homes. The practice had access to other agencies to support the older population, such as Rapid Response, Gateway to Care, Accessible Home Team and the falls prevention service.

Updated 24 September 2015

The practice is rated as good for the care of working age people (including those recently retired and students). Regular NHS health checks were offered to patients for the early detection and prevention of diseases, such as cardiovascular. The practice had extended hours one evening per week until 8pm. The practice provided online appointments and a prescription ordering service, which reflected the needs for this age group.

Updated 24 September 2015

The practice is rated as good for the care of people experiencing poor mental health, including people living with dementia. The practice offered longer appointments and home visits as needed for all patients who had poor mental health or dementia. The practice had in-house input from a counsellor and had access to primary care psychological therapies. The practice used the dementia enhanced service as part of the dementia identification scheme. Although they were not signed to the scheme they followed it as good practice.

Updated 24 September 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice had a system in place for identifying patients living in vulnerable circumstances including those with a learning disability. Patient status alerts were used within the clinical system to make staff aware when they are dealing with a vulnerable patient. The practice used Clinical meetings in the case management of vulnerable people. The practice worked collaboratively with local agencies to maintain the physical and social well-being needs of vulnerable population groups, such as the homeless and patients with a learning disability. Information about patients’ health was provided in a format patients could understand. Carers, advocates or case workers were invited to attend with patients on their appointments to provide additional support.