Archived: Greyfriars Surgery

Updated 19 March 2015

Greyfriars Surgery provides a primary medical service to patients who live within the city of Hereford or in some of the surrounding villages. The practice population reflects the average patient population for England in respect of social deprivation. The practice has estimated that the majority of its patients speak English.

The practice has one female and three male GP partners. It is a training practice and when we visited, a GP registrar was undertaking their specialist training to become a GP there. The practice employs a nurse practitioner, three practice nurses and two healthcare assistants, all of whom are female. A practice manager leads a team of reception and administrative staff.

The practice has a contract to provide general and enhanced medical services.

We have not received any information describing concerns about this practice.

This practice does not provide out of hours care to its patients. The Herefordshire Clinical Commissioning Group (CCG) contracts with other providers to provide out of hours care for all patients living in the county. The Greyfriars Surgery website and leaflet advise patients to telephone 111 if they need urgent medical care when the surgery is closed.

The GPs at Greyfriars Surgery together with other GPs across the Herefordshire CCG area owned and managed an extended hours service. Patients were able to book appointments with this service from the practice.

Updated 19 March 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on 27 October 2014.

We have rated this practice as good overall. We found the practice to be good in the safe, effective, caring, responsive and well-led domains. We found the practice provided good care to older people; people with long term conditions; families, children and young people; the working age population and those recently retired; people in vulnerable circumstances and people experiencing poor mental health.

Our key findings were as follows:

• Patients were positive about the helpfulness, care and treatment provided by all the staff at Greyfriars Surgery.
• Patients received safe care because information about safety was recorded, monitored, reviewed appropriately and addressed.
• The practice team understood the needs of their patient population and staff worked flexibly to ensure that every patient could access the best possible care.
• The practice had established a learning culture for the benefit of all groups of staff and for patients.

However the provider should:

• Ensure that there is clear evidence that patients’ consent has been sought and obtained before minor surgery is undertaken.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 March 2015

Nurses who have received specialist training provide care for patients with long-term conditions such as diabetes and respiratory disease. Patients were reviewed annually or, in the case of patients with diabetes, twice a year.

Patients with Type 2 diabetes were supported by the practice to make the transition from oral medicines to injectable medicines when they need to. This enabled them to have continuity of care from the practice. The practice has supported patients with chronic obstructive airways disease to have greater input in managing their condition through using on-line access to their records. The practice team included a GP who was also a cardiologist and continued to work in that specialism.

Updated 19 March 2015

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 of poor health outcomes. The practice provided a baby clinic and appointments were available outside of school hours.

The premises were suitable for children and babies. We saw good examples of joint working with midwives and health visitors. Emergency processes were in place and referrals were made for children and pregnant women whose health deteriorated suddenly.

Updated 19 March 2015

Patients aged over 75 have a named GP for continuity of care. GPs made home visits to patients when they needed them. Patients who lived in care homes benefited from a weekly visit by a named GP with telephone contact to follow up patients.

Feedback from a care home manager described improved continuity of care for patients who lived in the care home as a result of having a nominated GP. They also referred to excellent response times when the manager had concerns about their resident patients and very high standards of palliative care to ensure those patients’ needs were met at the end of their life.

Updated 19 March 2015

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 works flexibly to ensure the services it offered were accessible 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.

Updated 19 March 2015

The practice is rated as good for the care of people experiencing poor mental health, including people with dementia. The practice regularly worked with multi-disciplinary teams to support patients experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia and provided appropriate information for them or referred them to other teams.

Updated 19 March 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice held a register of patients who needed end of life care and offered these patients a caring and compassionate service from a named GP of their choosing. The practice held a register of patients with a learning disability. It had set up systems for carrying out annual health checks for this group and had completed annual reviews. Appointments were flexible so that patients had enough time to express any concerns they had. The practice offered ‘shared care’ in conjunction with a local team who supported patients with alcohol and substance abuse problems.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It provided information 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.