Skelmanthorpe Family Doctors

Updated 13 December 2016

Skelmanthorpe Family Doctors, The Health Centre, Commercial Road, Skelmanthorpe Huddersfield, HD8 9DA, provides services for 9,300 patients. The provider operates from two locations situated within the Greater Huddersfield Clinical Commissioning Group and delivers primary medical services under the terms of a personal medical services (PMS) contract.

Services are provided within purpose built and accessible buildings. The main location at Skelmanthorpe village is leased from NHS Property Services. The branch surgery, located at 313 Wakefield Road, Denby Dale, Huddersfield, HD8 8RX is owned by the partners. The provider is located in a rural area to the south of Huddersfield.

The population experiences lower than average levels of deprivation and is mainly White British. Skelmanthorpe Family Doctors is registered as a partnership between Dr Michael Welch, Dr Nicholas Kaye, Dr Stephen Ollerton and Dr Louise James. The four partners work a whole time equivalent (W.T.E) of three full time GPs. They are supported by two salaried GPs (both female) who both work half time. The provider also has two advanced nurse practitioners (both female) who work full time. The practice also has a part time female practice nurse equivalent to 0.7 W.T.E, a pharmacist 0.2 W.T.E and two health care assistants 1.73 W.T.E.

The practice manager is supported by 13 part time reception and administrative staff.

The practice at Skelmanthorpe is open Monday, Thursday and Friday from 8am to 6pm and Tuesday and Wednesday from 7am to 6pm. The branch at Denby Dale is open from 8am to 12 pm, Monday to Friday. Appointments are available throughout the day at Skelmanthorpe and during the morning at Denby Dale.

When the surgery is closed patients are advised of the NHS 111 service for non –urgent medical advice and are directed to a local out of hours provider, Local Care Direct.

Updated 13 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Skelmanthorpe Family Doctors on 8 September 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. A lunchtime safety meeting was held at the practice each day to review any concerns.
• Risks to patients were assessed and well managed.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said 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.
• An on-call clinician ensured that home visits could be undertaken late into the afternoon for urgent cases and also reviewed key correspondence on day of receipt to ensure results and correspondence from secondary care was dealt with promptly.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from the patient participation group. For example, improving the appointment and telephone answering systems.
• Vulnerable patients including those with a cancer diagnosis or a serious mental illness were followed up by the GPs if an appointment was missed.

• The provider had implemented the use of virtual onlineconsultations underpinned by a clear clinical protocol to widen accessibility of appointments for patients. A consultation by email protocol was also being piloted by the practice.

• 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. For example, by moving the time of the baby clinic and coordinating this with a childhood immunisation clinic.
• The provider was aware of and complied with the requirements of the duty of candour and had a clear policy statement. In addition, a policy called Being Open underpinned their approach to honesty and integrity, ensuring that all staff were aware of their duty of care.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 13 December 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.

• Overall QOF achievement for treatment of diabetes was 9% higher than the local average and 7% higher than the national average and was achieved with lower than average exception reporting.

• 84% of patients with asthma received an annual review which was 10% higher than the local average and 13% higher than the national average and was achieved with lower than average exception reporting of 2% which was 4% lower than the local average and 6% below the national average.

• Longer appointments and home visits were available when needed. The practice combined reviews wherever possible to minimise the number of appointments required and sent text reminders to patients.

• 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 or advanced nurse practitioner worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 13 December 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 accident and emergency (A&E) attendances. Immunisation rates were relatively high for all standard childhood immunisations.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• A full range of family planning services were provided and sexual health support for young people was offered, including chlamydia screening.

• Uptake for the cervical screening programme was 86%, which was higher than the CCG average of 85% and the national average of 81%.

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

• We saw positive examples of joint working with midwives and health visitors. In response to patient feedback the baby clinic and post-natal & immunisation clinic were coordinated to take place at a time more convenient for parents.

Updated 13 December 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. Housebound patients were supported by clinical staff offering long term conditions and medication reviews in the patient’s own home

• A care home protocol had been written to support visits and communication with six local care homes linked to the practice and a weekly proactive visit to each care home was undertaken by an advanced nurse practitioner. The practice pharmacist also visited the care homes regularly to offer support and advice.

Updated 13 December 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.

• Early morning appointments were offered on two days a week for people unable to attend the surgery during the standard working day. Appointments by telephone, via online media or email were also available.

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

Updated 13 December 2016

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

• 78% of patients diagnosed with dementia  had had their care reviewed in a face to face meeting in the last 12 months, which was  6% lower than the national average.

• 93% of eligible patients experiencing a serious mental illness had an up to date care plan. This was 4% higher than the national average.

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

• The practice carried out advance 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. A GP partner had a special interest in supporting patients experiencing mental illness and we saw evidence that these patients were flexibly and compassionately supported.

• 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.

Updated 13 December 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 and those with a learning disability.

• Patients with a cancer diagnosis or a serious mental illness were followed up by the practice if they missed an appointment.

• The practice offered longer appointments for patients with a learning disability and undertook annual reviews in their home environment if indicated as preferable.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients. For example; a weekly Shared Care clinic for patients experiencing difficulties with addiction was offered at the practice.

• 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.