Background to this inspection
Updated
11 September 2018
Elmwood Family Doctors is located in one of the less deprived areas of Huddersfield. At the time of our inspection there were 14,762 patients on the practice list. The practice provides Personal Medical Services (PMS) and also offers enhanced services for various immunisation checks, has extended hour’s access, remote care monitoring, minor surgery, learning disability, alcohol and people living with dementia health check schemes.
The practice has five male GPs, three female GPs, three female practice nurses, two female healthcare assistants, a practice manager, an assistant practice manager and an extensive administrative team.
The practice opening times are Monday to Friday 8am till 6.30pm. Surgery opening times are Thursday and Friday 8am to 6pm. Extended hours are Monday, Tuesday and Wednesday 8am till 8pm (pre-booked appointments only). When the practice is closed, out of hours cover for emergencies is provided by Local Care Direct.
The practice has two sites (we visited both as part of the inspection):
Main: Huddersfield Road, Holmfirth, HD9 3TR.
Branch: Parkin Lane, Meltham, HD9 4EN.
Practice website: www.elmwoodhealthcentre.co.uk
The practice catchment area is classed as being within one of the least deprived areas in England. The practice scored nine on the deprivation measurement scale; the deprivation scale goes from one to 10, with one being the most deprived. People living in more deprived areas tend to have greater need for health services. National General Practice Profile describes the practice ethnicity as being 97.7% white British, 0.7% Asian, 0.3% black, and 1.1% mixed and 0.1% other non-white ethnicities.
The practice demographics show a slightly higher than average percentage of people in the 75+ year age group. Average life expectancy is 80 years for men and 85 years for women compared to the national average of 79 and 83 years respectively. The general practice profile shows that 61% of patients registered at the practice have a long-standing health condition, compared to 52% locally and 54% nationally.
When we returned to the practice for this inspection, we checked, and saw that the previously awarded ratings were displayed, as required, in the practice premises. The overall rating was displayed on the practice website with a link to the inspection report.
Elmwood Family Doctors is registered with the Care Quality Commission to provide the following regulated activities:
- Diagnostic and screening procedures
- Treatment of disease, disorder or injury
- Family planning
- Maternity and midwifery services
- Surgical procedures
Updated
11 September 2018
This practice is rated as Outstanding overall. (Previous rating 12 August 2015 – Good overall, with the key question of safe rated as requires improvement.)
The key questions at this inspection are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Outstanding
Are services well-led? - Outstanding
We carried out an announced comprehensive inspection at Elmwood Family Doctors on 10 July 2018 as part of our inspection programme.
At this inspection we found:
- The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
- The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
- The practice had a significant number of patients residing in homes for older people. They provided a weekly ‘walk around’ with a supporting detailed policy to monitor the health and well-being of this group of patients. The practice was able to demonstrate that only one of their registered patients who resided in care homes had died in hospital in the last three and a half years.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients spoke positively about the care they received from the practice, which was in line with the friends and family test and above the national average for the results in the national GP patient survey data 2017.
- There were high levels of staff and patient satisfaction. Staff were proud of the organisation as a place to work and spoke highly of the culture.
- Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
- There was a focus on continuous learning and improvement at all levels of the organisation.
- Staff told us the leadership team was supportive and approachable.
- The practice was organised, efficient, had effective governance processes and a culture which was embedded effectively and used to drive and improve the delivery of high-quality person-centred care.
- The involvement of other organisations, voluntary services and the local community were integral to how services were planned and ensured that services met patient’s needs.
- The leadership, governance and culture were used to drive and improve the delivery of high-quality person-centred care and were clear, supportive and encouraged creativity.
- The practice was an active National Institute Healthcare Research (NIHR) centre. This benefitted patients by accessing potential screening, treatment and resources.
- The practice is also a Royal College of General Practitioners surveillance site for monitoring of disease trends and feeding this information into public health, helping predict and manage flu outbreaks and pandemics.
We saw areas of outstanding practice:
- The practice had developed the ‘Elmwood Template Menu’ and embedded it within the service to ensure all clinicians were using up to date agreed templates. We were told that this reduced variability in using read codes as well as improving the safety of work carried out by new members of staff, clinical trainees and locums. The templates also promoted patient safety, with prompts for clinicians during and after the consultations to ensure referrals and investigations were completed.
- Services were tailored to meet the needs of individual people are were delivered in a way to ensure flexibility, choice and continuity of care. The practice had identified areas where there were gaps in service provision locally and had taken steps to address these. Feedback received from patients and other stakeholders on the changes made was positive.
- The practice had designed, developed and improved processes for ensuring it maintained its ability to deliver both urgent and routine GP appointments in order to meet its patient’s needs. The system identified patient demand for appointments after a long-term audit of appointment availability and use, analysing capacity and patient demand. The results were used to ensure sufficient urgent appointments were provided each day, linked to demand. The impact had been a significant reduction in the volume and unpredictability of unscheduled work. We were told this led to less pressure and stress for patients and staff.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice
Please refer to the detailed report and the evidence tables for further information.