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Priory View Medical Centre Good

Inspection Summary


Overall summary & rating

Good

Updated 11 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Priory View Medical Centre on 17 August 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 one area where the provider should make improvement are:

  • The practice should review their arrangements to meet patients’ language and communication needs alongside best practice guidelines. This is in order to assure themselves they are taking all steps possible to maintain patient confidentiality and safety.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 11 January 2017

The practice is rated as good for providing safe services.

  • There was an effective system in place for reporting and recording significant events
  • Lessons were shared to make sure action was taken to improve safety in the practice.
  • When things went wrong patients received reasonable support, truthful information, and a written apology. They were told about any actions to improve processes to prevent the same thing happening again.
  • The practice had clearly defined and embedded systems, processes and practices in place to keep patients safe and safeguarded from abuse.
  • Risks to patients were assessed and well managed. However; we noted one area of risk as on occasion, family members were used as interpreters. This could raise concerns around potential confidentiality and safeguarding issues.

Effective

Good

Updated 11 January 2017

The practice is rated as good for providing effective services.

  • Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were at or above average compared to the national average.
  • Staff assessed needs and delivered care in line with current evidence based guidance.
  • Clinical audits demonstrated quality improvement.
  • Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • There was evidence of appraisals and personal development plans for all staff.
  • Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs.

Caring

Good

Updated 11 January 2017

The practice is rated as good for providing caring services.

  • Data from the national GP patient survey showed patients rated the practice higher than others for several aspects of care.
  • Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.
  • Information for patients about the services available was easy to understand and accessible.
  • We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.

Responsive

Good

Updated 11 January 2017

The practice is rated as good for providing responsive services.

  • Practice staff reviewed the needs of its local population and engaged with the NHS England Area Team and Leeds West Clinical Commissioning Group (CCG) to secure improvements to services where these were identified. For example; the practice had adopted the House of Care approach for the chronic disease management of diabetes within the practice. This was aimed at encouraging patients with diabetes to understand their condition and select their own personal health and lifestyle targets. The practice was also involved in the quality improvement scheme for 2015/16, working with two other practices to increase the identification of patients with pre-diabetes and diabetes.
  • The practice was part of the Patient Empowerment Project which aimed to improve the health and wellbeing of patients. Through this project, GPs were provided with a link to refer patients to local groups and community activities within the voluntary sector. Patients were then provided with support to help them develop the skills, knowledge and confidence to manage their condition.
  • 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 used a text messaging service to remind patients about their appointments, patients could also cancel their appointments via this method. This service was also used to advise patients when the practice was running health campaigns.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • Information about how to complain was available and easy to understand and evidence showed the practice responded quickly to issues raised. Learning from complaints was shared with staff and other stakeholders.
  • Patients at the practice could access additional services such as a vasectomy service and a dermatology service which were also available to all patients in the Leeds West area.

Well-led

Good

Updated 11 January 2017

The practice is rated as good for being well-led.

  • The practice had a clear vision and strategy to deliver high quality care and promote good outcomes for patients. Staff were clear about the vision and their responsibilities in relation to it.
  • There was a clear leadership structure and staff felt supported by management. The practice had a number of policies and procedures to govern activity and held regular governance meetings.
  • There was an overarching governance framework which supported the delivery of the strategy and good quality care. This included arrangements to monitor and improve quality and identify risk.
  • The provider was aware of and complied with the requirements of the duty of candour. The partners encouraged a culture of openness and honesty. The practice had systems in place for notifiable safety incidents and ensured this information was shared with staff to ensure appropriate action was taken
  • The practice proactively sought feedback from staff and patients, which it acted on. The patient participation group was active.
  • There was a strong focus on continuous learning and improvement at all levels.
Checks on specific services

People with long term conditions

Good

Updated 11 January 2017

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.
  • Overall performance for diabetes related indicators was lower than the CCG and national average. However, the practice had performed better in some areas. For example; 93% of patients newly diagnosed with diabetes, on the register, in the preceding 12 months had been referred to a structured education programme. This was better than the CCG average of 89% and national average of 92%.
  • 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.
  • The practice had adopted the House of Care approach for chronic disease management of diabetes within the practice. This was aimed at encouraging patients with diabetes to understand their condition and select their own personal health and lifestyle targets.
  • The practice was also involved in the quality improvement scheme for 2015/16, working with two other practices to increase the identification of patients with pre-diabetes and diabetes.

Families, children and young people

Good

Updated 11 January 2017

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 (A&E) attendances. Immunisation rates were relatively high for all standard childhood immunisations.
  • The practice offered booked appointments for childhood vaccinations rather than specific clinics. This was to ensure appointments were booked at a time to suit families.
  • The practice carried out audits to identify any patient not attending for childhood vaccinations and these patients were contacted in writing.
  • 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.
  • The practice offered a full range of contraceptive services including implants and emergency contraception.
  • 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 midwife held ante-natal clinics twice a week from the practice for patients to access.

Older people

Good

Updated 11 January 2017

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.
  • The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
  • The health care assistants and nursing staff within the practice offered health checks and hospital discharge reviews.
  • The practice offered home visits for influenza, shingles and pneumonia vaccinations for those patients who were unable to access the surgery.
  • The practice had assigned a nurse to provide services to care homes; the nurse liaised closely with GPs within the practice.
  • A GP partner worked closely with local neighbourhood teams and held regular meetings to ensure effective care for patients.

Working age people (including those recently retired and students)

Good

Updated 11 January 2017

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.
  • NHS health checks were offered to all patients aged between 40 and 74.
  • 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. These were utilised by patients at the practice, with 52% of patients registered to use online services.
  • The practice offered appointments outside of normal working hours six days per week, including Saturday mornings.
  • The practice offered telephone triage appointments where patients could speak with a GP and access a same day appointment if required.

People experiencing poor mental health (including people with dementia)

Good

Updated 11 January 2017

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

  • Data showed that 85% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the CCG average of 87% and national average of 84%
  • 90% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive care plan, documented in the record, in the preceding 12 months. This was better than the CCG average of 85% and national average of 89%.
  • The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
  • All staff within the practice had received dementia awareness training.
  • 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.
  • 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.

People whose circumstances may make them vulnerable

Good

Updated 11 January 2017

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 homeless people, travellers and those with a learning disability.
  • The practice offered longer appointments for patients with a learning disability.
  • The practice regularly worked with other health care professionals in the case management of vulnerable patients.
  • 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.