Archived: Haworth Medical Practice

Updated 29 July 2016

Haworth Medical Practice is a mixed urban and rural practice located in Haworth near Keighley, West Yorkshire. The area is in the third least deprived areas nationally and serves a patient list of 9300 people. The practice is located in a purpose built single site surgery in the centre of the village and shares the premises with other community health services, such as district nurses and health visitors and a number of mews homes. The practice has level access to all patient areas and consulting rooms, and on site car parking, including disabled parking bays.

The practice has nine GPs (three male and six female GPs), five nurses (three nurses and two advanced nurse practitioners) and a healthcare assistants.

The practice was open between 8am and 6pm Monday to Friday and Monday evenings 6.30pm to 8.30pm. The practice was also open for prebooked appointments from 7.30am on Tuesdays with the nurse and Fridays with the GP.

Medicines were dispensed for patients who did not live near a pharmacy.

Out of hours care is provided by Local Care Direct

We visited the single site premises at Heathcliffe Mews, Haworth, Keighley.

Updated 29 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Haworth Medical Practice on 11 May 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 usually could arrange appointments with their preferred doctor and urgent appointments were 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.

We saw one area of outstanding practice:

• The practice offered a level 2 diabetes clinics (where patients could be commenced on insulin therapy without attending hospital).

The areas where the provider should make improvements are:

• Identify an appropriate checking system for dispensed medication and implement this.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 29 July 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.
• Patients with multiple long term conditions were offered 30 minute appointments with the nurse to holistically manage the conditions.
• Over 85% of patients with diabetes have a blood sugar reading within normal range in the preceding 12 months, compared to 78% nationally.
• Over 96% of patients on the diabetes register received the influenza immunisation in the preceding September to March period, compared to 94% nationally.
• The practice offered a level 2 diabetes clinic where patients could be commenced on insulin therapy without the need to attend hospital outpatients.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.
• The practice offered level 2 diabetic clinics where patients could be commenced on insulin therapy without the need to attend hospital outpatients.

Updated 29 July 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.
• The percentage of women aged 25 to 64 years who had a cervical screening recorded as being performed in the preceding five years was 82%, the same as the national average
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw good examples meeting minutes of joint working with midwives, health visitors and school nurses.

Updated 29 July 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.
• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice organised the home delivery of medication from the dispensary to eligible patients.
• The practice conducted joint visits with the district nursing team where appropriate.
• The practice participated in a local enhanced primary care scheme. Practice and community staff carried out advanced care planning, they also conducted a weekly ward round of care homes registered with them and educate care home staff.

Updated 29 July 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.
• The practice offered early morning and late evening appointments for this population group.
• The practice operated a General Practitioner with Special Interests (GPwSI) musculoskeletal service for the practice population and neighbouring practices from the surgery, supported by secondary care consultants

Updated 29 July 2016

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

• Data showed that 87% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan documented in the record, in the preceding 12 months was 98%, higher than national average of 88%.
• The practice regularly worked with multidisciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• It 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.
• It 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 people with mental health needs and dementia.

Updated 29 July 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• It offered longer appointments for people with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• It had told 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.