Archived: Faith House Surgery

Updated 9 November 2016

Faith House Surgery, 723 Beverley Road, Hull, HU6 7ER has a clinical team of three GP partners, one of who is male and two are female. There are two practice nurses, an urgent care practitioner who is also a paramedic, a healthcare assistant and a phlebotomist. It is a teaching practice with regular intakes of foundation level two doctors and regularly uses locum doctors. A practice manager and IT manager are in post and are supported by secretaries, a summariser and a team of receptionists and administrators.

The practice has baby changing facilities and promotes a positive environment for breast feeding. Accessible toilets are available and patient wifi access is available in the waiting areas. Patients can check-in using a self-service kiosk, which provides guidance in multiple languages or at the manned reception desk. The practice has two floors and a wheelchair-accessible lift is available.

The practice serves a patient list of 7,672, including 150 registered carers and is in an area of deprivation.

Appointments are from 8.30am to 6pm Monday to Friday and from 9am to 12.45pm on Saturdays.

54% of patients are of working age, compared to the England average of 67%. The practice has a lower number of patients with a long-standing health condition 50% compared with a national average 54%.

We had not previously carried out an inspection at this practice.

Updated 9 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Faith House Surgery on 13 June 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 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.
• 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 areas of outstanding practice:

• The practice had established pathways to provide holistic care for older people that included consideration of their social needs. For example, clinical staff worked one-to-one with patients to implement preventative health promotion strategies in their everyday lives to reduce the risk of falls, fractures and pneumonia. Staff were proactive in maintaining contact with such patients and actively encouraged them to seek help and advice in a way that empowered them and reduced the risk they would not contact the practice for fear of wasting staff time.
• The practice had introduced a new clinical role, an urgent care practitioner, led by a qualified paramedic. This member of staff provided additional capacity to treat a number of illnesses and injuries. This meant patients had more rapid access to appointments and provided GPs with more capacity to see patients with complex needs.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 9 November 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.
• 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. 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.
• Staff proactively contacted patients who missed appointments to ensure continuous care was provided.
• The practice engaged with district nurses and a palliative care consultant to ensure end of life care was provided in line with the Gold Standards Framework.

Updated 9 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 accident and emergency attendances. Children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• Antenatal clinics were available and staff offered postnatal check ups.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with health visitors and school nurses.

Updated 9 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 and provided this within an understanding of the relative levels of deprivation and risk of social isolation in the local area.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. Clinical staff provided care for 66 patients in 12 residential care homes and conducted regular visits to ensure the needs of all patients were met.
• There was a continual focus on working with older people to improve their health and wellbeing through preventative measures and health promotion strategies. This included a holistic approach to ensuring patients were empowered to raise social issues and concerns and to speak to clinical staff without worrying about taking up their time.
• Clinical staff worked one-to-one with patients to implement preventative health promotion strategies in their everyday lives to reduce the risk of falls, fractures and pneumonia.
• Practice nurses offered annual healthy heart checks and the practice offered dementia and cognitive screening for older people.

Updated 9 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.
• 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. This included nurse-led health checks and active follow-up and recall for cervical screening.
• The practice offered sexual health guidance and referrals and health checks tailored to the needs of students.

Updated 9 November 2016

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

• 88% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which was better than the national average of 84%.
• 95% of patients with schizophrenia, bipolar affective disorder and other psychoses had a documented care plan in the last 12 months, which was better than the national average of 88%.
• 95% of patients with schizophrenia, bipolar affective disorder and other psychoses had their alcohol consumption recorded in the last 12 months, which was better than the national average of 90%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. This included working with community mental health teams to provide at-home support to patients in crisis.
• The practice carried out advance care planning for patients with dementia using memory assessment tools.
• The practice supported patients experiencing poor mental health to access various support groups and voluntary organisations.
• 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 9 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. Such patients were offered longer appointments and annual health checks. The practice also monitored patients who were at risk of accident and emergency attendances and offered regular health checks to help them access more appropriate care.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients, including social services and specialist doctors.
• Staff demonstrated attention to detail in identifying the vulnerabilities that could affect patient’s safety and wellbeing. For example, a member of staff had arranged for the fire service to work with a patient one-to-one in their home to make it safe after they became concerned about safety during a home visit.
• 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. There was evidence staff had taken appropriate rapid action in cases where they suspected a young person was at risk.
• A partner had undertaken PREVENT training in line with Home Office standards, which enabled them to ensure the practice reacted appropriately to evidence of child radicalisation. This training was being delivered to all practice staff along with clinical training on supporting patients who had undergone female genital mutilation.
• The practice maintained a list of patients with needs relating to drug use, including those prescribed methadone. A partner had undertaken specialist training to be the named lead for the patients and provided holistic care and support to them alongside a drug liaison worker, who attended the practice twice weekly. Patients were able to see a doctor on an ad-hoc basis, which meant they could be seen during a time of crisis or elevated need.