22 April 2016
Parkside Medical Practice provides services for 3450 patients. The surgery is situated within the Bradford City Clinical Commissioning group (CCG), and is registered with CQC to provide primary medical services 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.
Parkside Medical Practice is registered to provide diagnostic and screening procedures, treatment of disease, disorder or injury, maternity and midwifery services, surgical procedures and family planning. The practice is a registered yellow fever centre.
The practice offers a range of enhanced services such as childhood immunisations and extended opening hours to facilitate access to appointments.There are similar numbers of male and female patients.
The practice figures show that 56% of the practice population are from an Asian background, with a further 12% of the population belonging to other ethnic minority groups. The practice supports a higher than average number of patients under the age of 34 which is in common with the characteristics of the Bradford City area. The practice catchment area is classed as being within one of the most deprived areas in England. Male life expectancy is 76 years compared with a CCG average of 73 and a national average of 79. Female life expectancy is 81 years CCG average 79, national average 83.
There are three GP partners, two of whom are female and one is male. In addition there are also 4 part time Locum GPs two are female and two are male. The practice does not currently have a substantive practice nurse but employs a part time locum nurse who was not available on the day of our visit. There is a full time assistant practitioner and a health care assistant (HCA) who works one morning per week. The newly recruited practice manager is currently working ten hours per week until May 2016 when they will take up a full time position. The practice also engages the services of a pharmacist for one day per week who works alongside the GPs. We were told of ongoing plans to recruit a pharmacist prescriber who would also be able to see patients.
The clinical team is supported by an assistant practice manager and a team of administrative staff. The staff team is reflective of the population it serves and are able to converse in several languages including those widely used by the patients, Urdu, Punjabi, Guajarati, Pushto and English.
Parkside Medical Practice is situated within a purpose built building with ground floor access. There are disabled facilities within the building and good parking.
The practice is open for reception and appointments between 8am to 6.30pm on a Monday, Tuesday, Wednesday and Friday. On a Thursday the practice opens at 8am and offers an extended hour’s clinic until 8pm.
The surgery is closed on a Saturday and Sunday.
When the practice is closed patients are advised to call 111.
The practice was inspected in October 2013 and was found to meet the required standards.
22 April 2016
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Parkside Medical Practice on 1 March 2016. Overall the practice is rated as good.
Our key findings across all the areas we inspected were as follows:
- 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.
- There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events, but the outcomes from these were not always documented and shared.
- Risks to patients were assessed and well managed.
- GP Patient survey results showed that patients did not always feel that they were treated with compassion, dignity and respect and involved in their care and decisions about their treatment and it was difficult to make an appointment with a named GP. The practice was aware of this and had taken steps to improve patient outcomes.
- Information about services and how to complain was available and easy to understand.
- 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 upon. The practice was in the process of making significant changes to meet patient’s needs.
- The provider was aware of and complied with the requirements of the Duty of Candour.
The areas where the provider should make improvement are:
The practice should continue to review the results of patient satisfaction surveys and ensure that it can meet the needs of the patient population in the future and improve outcomes.
The practice should ensure that outcomes from significant events are documented and shared with the staff team.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
22 April 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. The practice had recently appointed an additional advanced nurse practitioner to increase clinics and access for patients.
- Diabetes related indicators were comparable to other practices for example, 98% of diabetic patients had a flu vaccination compared with the national average of 94% and 68% of patients had a blood pressure reading which was within normal limits, compared to the national average of 78%.
- 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 and provide written care plans where appropriate.
- The practice actively participated in the CCG initiatives Bradford breathing better and Bradford beating diabetes. Identification of patients with diabetes had risen from 9% of the practice population to 12% under the scheme.
- The practice had developed several clear protocols for the management of several long term conditions. These protocols detailed when and how referrals should be made and identified those at considered to be at risk.
22 April 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 A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations. The practice would follow-up children who had did not attend for vaccinations.
- The practice had identified that 6% of the patient population was diagnosed with asthma, 91% of these patients had attended for a review in the past 12 months compared to the national average of 75%.
- 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.
- In the last five years 82% of eligible women had attended for cervical screening which was the same as the national average.
- 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, health visitors and school nurses. The practice held quarterly meetings with the health visiting team to discuss safeguarding concerns or children with complex health needs.
22 April 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 worked closely with the community matron to avoid unplanned admissions and complete care plans.
- The practice was responsive to the needs of older people, and offered home visits, same day face to face appointments or telephone consultations.
- The practice referred to social organisations when older people were identified as being lonely.
- The practice had recently purchased an electrocardiogram ( ECG) machine to increase access to local services for older people and reduce hospital visits.
22 April 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 surgery was open until 8pm on a Thursday and offered telephone consultations for those who could notattend the surgery.
- The practice was proactive in offering online services, including the booking of appointments, as well as a full range of health promotion and screening that reflects the needs for this age group.
- The practice offered text reminders for appointments.
22 April 2016
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).
- 71% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is lower than the national average of 84%
- Patients at risk of developing dementia were identified and opportunistic screening undertaken using a recognised assessment tool. A protocol had been developed to support this.
- The percentage of patients with a mental health issue who had an agreed care plan within the last 12 months was 78% compared with the national average of 88%. However, 99% of patients with a physical or mental health issue had their smoking status recorded which is above the national average of 94%.
- The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It was participating in a CCG initiative to offer proactive additional physical health checks for patients with serious mental illness
- 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. There was information in the reception area to support this.
- 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.
22 April 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 circumstances which may make them vulnerable including homeless people and those with a learning disability.
- The practice offered longer appointments for patients with a learning disability. We were told of an example where a patient with a learning disability attended the surgery several times to familiarise themselves with staff and equipment. Following this the patient agreed to have necessary bloods taken.
- The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
- 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. Recent training had included how to identify those at risk of forced marriages and female genital mutilation.
- The practice had a mobile telephone number so that patients who were deaf or hard of hearing could communicate with the surgery by text message.