Archived: Hedon Group Practice

Updated 29 July 2016

Hedon Group Practice is located in the centre of Hedon and is close to local bus routes. There is public parking available on the roads outside the practice and public car parks within five minutes’ walk of the practice. The practice is in an adapted Georgian listed building with consulting and treatment rooms available on the ground and first floors; there is lift access to the first floor. There is one branch site in Keyingham which was five miles from Hedon; this was also visited during the inspection.

The practice provides services under a General Medical Services (GMS) contract with the NHS North Yorkshire and Humber Area Team to the practice population of 12017, covering patients of all ages. The practice is a ‘dispensing practice’ and is able to dispense medicines for patients who live more than one mile from the nearest pharmacy.

The proportion of the practice population in the 65 years and over age group and the under 18 age group is similar to the England average. The practice scored eight on the deprivation measurement scale, the deprivation scale goes from one to ten, with one being the most deprived. People living in more deprived areas tend to have a greater need for health services.

The practice has eight GP partners and a salaried GP, three are full time and six are part time. There are four male and five female GPs. There are six practice nurses and five health care assistants, all female and all work part time. There is a business manager, a practice manager and a team of administrators, secretaries and receptionists. There is a pharmacist and 13 dispensary assistants.

The Hedon surgery is open between 8am to 6pm Monday to Friday. Appointments are available from 8.30am to 11.00am and 4pm to 6pm Monday to Friday. There is extended opening on a Monday until 8pm with appointments from 6.30pm to 7.40pm and on a Saturday morning from 8.30am to 11.30am with appointments from 8.30am to 10am. There is a sit and wait surgery from 8.30am to 10am and 4pm to 5.30pm each day for patients who cannot get an appointment and need to be seen urgently.

The Keyingham surgery is open between 8.30am and 12pm with appointments available from 8.40am to 11am on Monday. From 8.30am and 11.15pm with appointments available from 8.40am to 11am on Tuesday. From 8.30am and 12.30pm with appointments available from 8.40am to 11am on Wednesday. From 8.30am and 11.15am with appointments available from 8.40am to 11am on Thursday and from 8.30am and 12.15pm with appointments available from 8.40am to 11am on Friday. The surgery is open between 4pm and 6pm with appointments available from 4pm to 6pm and a Monday, Wednesday and Friday.

Information about the opening times is available on the website and in the patient information leaflet.

The practice, along with all other practices in the East Riding of Yorkshire CCG area have a contractual agreement for the Out of Hours provider to provide OOHs services from 6.00pm. This has been agreed with the NHS England area team.

The practice has opted out of providing out of hours services (OOHs) for their patients. When the practice is closed patients use the 111 service to contact the OOHs provider. Information for patients requiring urgent medical attention out of hours is available in the waiting area, in the practice information leaflet and on the practice website.

The practice is a training practice for GP registrars and a teaching practice for year two and year five medical students from the Hull York Medical School. The practice is also a training hub for student nurses.

Updated 29 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hedon Group Practice on 26 April 2016. 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they were able to get same day appointments and pre bookable appointments were available.
• 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 an area of outstanding practice:

• As part of the dispensing service the practice delivered 25000 prescription items annually at no cost to the patients, to their own homes so they did not have to travel to the practice to collect them.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Make sure that fridge temperatures are monitored and recorded in accordance with national guidance.

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 (LTCs).

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Nationally reported data for 2014/2015 showed that outcomes for patients with long term conditions were good. For example, the percentage of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months was 95% compared to the local CCG and England average of 88%.

• Longer appointments and home visits were available when needed.

• Patients with LTCs 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 GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care.

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 A&E attendances or who failed to attend hospital appointments.

• Immunisation rates were high for all standard childhood immunisations. For example, rates for all immunisations given to children aged 12 months, 24 months and five years were 94% or above.

• 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.

• Nationally reported data from 2014/2015 showed the practice’s uptake for the cervical screening programme was 84% compared to the local CCG average of 85% and the England average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• A joint six week check-up was provided for new mums and their baby for them to see the GP and nurse and any required vaccinations were given. An assessment for post natal depression was also provided for new mums.

• We saw good examples of joint working with midwives, health visitors and school nurses.

  The practice monitored any non-attendance of babies and children at vaccination clinics and worked with the health visiting service to follow up any concerns.

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. Patients over the age of 75 had a named GP.

• The practice had assessed the older patients most at risk of unplanned admissions and had developed care plans which were reviewed every three months.

• The practice was delivering ‘A Care Home Scheme’. This ensured patients living in care homes had structured annual reviews which included a review of medication by a pharmacist, review of clinical care and advanced care planning with the GPs and nurses. The GPs reviewed the care of patients in the care homes each month.

• They were responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• One of the GPs was completing training to become a GP with a Special Interest in elderly medicine.

• Nationally reported data for 2014/2015 showed that outcomes were good for conditions commonly found in older people. For example, performance for heart failure indicators was 100%; this was 1.9% above the local CCG average and 2.1% above the England average.

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 reflected the needs for this age group.

• Telephone consultations were available every day with a call back appointment arranged at a time to suit the patient, for example during their lunch break.

• Late evening and Saturday morning appointments were available with the GPs. Nurses and health care assistants also provided extended hours for routine blood pressure tests and routine blood tests.

Updated 29 July 2016

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

• Nationally reported data from 2014/2015 showed 81% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the preceding 12 months. This was compared to the local CCG and England average of 84%.

• Nationally reported data from 2014/2015 showed the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive care plan documented in their record in the preceding 12 months was 98%. This was compared to the local CCG average of 91% and the England average of 88%.

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

• The practice carried out advanced care planning for patients with dementia.

• Staff had completed dementia training in May 2015 and the practice was given a ‘Dementia Friendly Award’. (A dementia friend is someone who learns more about what it is like to live with dementia and turns that understanding into action). A ‘lives alone’ code was placed on the notes of patients living with dementia and a ‘pop up’ reminder appeared on the screen when receptionists made an appointment for these patients. This prompted the receptionist to ring the patient to remind them of their appointment.

• The practice had a GP with a Special Interest (GPwSI) in dementia care.

• The practice had told patients experiencing poor mental health about how 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.

Updated 29 July 2016

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

• The practice held registers of patients living in vulnerable circumstances which included those with a learning disability.

• The practice offered longer appointments for people with a learning disability.

• Nursing staff used easy read leaflets to assist patients with learning disabilities to understand their treatment.

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

• The practice 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.

• Telephone interpretation services were available and information leaflets in different languages were provided when required.