Archived: Pinfold Surgery Also known as Dr Bance & Partners

Updated 14 June 2016

The practice of Dr Bance and Partners consists of three surgeries, a principal surgery Pinfold Surgery, Methley, and two large branch surgeries, Elizabeth Court Surgery in Airedale and Castleford Health Centre located in Castleford town centre. At the time of inspection the practice as a whole had over 15,000 patients. The practice is a member of the NHS Wakefield Clinical Commissioning Group (CCG).

Pinfold Surgery is located on Pinfold Lane, Methley, Leeds and has a practice list of 5,518 patients. The surgery is located in a modern purpose built premises. The surgery has on-site parking available for patients.

Elizabeth Court Surgery is located on Elizabeth Court, Airedale, Castleford and has a practice list of 5,035 patients. The surgery is located in a purpose built premises and has parking available for patients.

Castleford Health Centre is located on Welbeck Street, in the centre of Castleford; it has a practice list of 4,466 patients. The surgery is located in a purpose built premises which it shares with another GP practice. The surgery has limited parking available although a local authority car park is located within 20 metres of the practice.

All three surgeries are accessible for those with mobility issues and are located close to independent pharmacies.

The practice serves a post industrial area linked predominantly to mining and heavy industry. As a result the practice has a high prevalence of long term conditions, with 59% of patients reporting they had a long standing health condition compared to the England average of 54%. The population age profile shows that it is slightly under the England average for those over 65 years old (16% compared to the England average of 18%), whilst the age profile for under 18s is slightly above the England average (23% compared to the England average of 21%). Average life expectancy for the practice population is 76 years for males and 80 years for females (England average is 79 years and 83 years respectively). The practice serves some areas of higher than average deprivation being ranked in the third most deprived decile. The practice population is predominantly White British with just over 2% of the population being composed of non-white ethnic groups.

The practice provides services under the terms of the Personal Medical Services (PMS) contract and is registered with the Care Quality Commission (CQC) to provide the following services; treatment of disease, disorder or injury, diagnostic and screening procedures, family planning, surgical procedures and maternity and midwifery services. In addition to this the practice offers a range of enhanced local services including those in relation to:

• Childhood vaccination and immunisation

• Influenza and Pneumococcal immunisation

• Rotavirus and Shingles immunisation

• Dementia support

• Risk profiling and care management

• Support to reduce unplanned admissions.

• Minor surgery

• Learning disability support

As well as these enhanced services the practice also offers additional services such as those supporting long term conditions management including asthma, chronic obstructive pulmonary disease, diabetes, heart disease and hypertension and smoking cessation.

Attached to the practice or closely working with the practice is a varied team of community health professionals including health visitors, midwives, and members of the district nursing team.

The practice has four GP partners (male) and four salaried GPs (two male, two female) working at the practice. In addition there are three advanced nurse practitioners, one specialist diabetic nurse, four practice nurses, three healthcare assistants and an apprentice healthcare assistant. Clinical staff are supported by a practice manager, deputy practice manager, IT manager and an extensive administration and reception team.

The practice holds training practice status and offers training to registrars and medical students and currently hosts four GP registrars (female) and one Foundation Year Two doctor (male). Two GPs at the practice are accredited to support this training activity.

The practice offers a range of appointments, these include:

• Pre-bookable appointments

• On the day/urgent appointments

• Telephone appointments

Appointments can be made in person, via telephone or online.

Opening times for the three practice surgeries are as follows: .

Pinfold Surgery

Monday 8am to 6pm

Tuesday 8am to 12.30pm

Wednesday 8am to 6pm

Thursday 8am to 6pm

Friday 8am to 6pm

Elizabeth Court Surgery

Monday 8am to 6pm

Tuesday 8am to 6pm

Wednesday 8am to 6pm

Thursday 8am to 1.30pm

Friday 8am to 6pm

Castleford Health Centre

Monday 8am to 6.30pm

Tuesday 8am to 6.30pm

Wednesday 8am to 6.30pm

Thursday 8am to 6.30pm

Friday 8am to 6.30pm

The practice does not offer extended hours opening.

Appointments can be made in person, via telephone or online.

Out of hours care is provided by Local Care Direct and is accessed via the practice telephone number or patients can contact NHS 111.

Updated 14 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Bance and Partners on 31 March 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, recording and taking remedial action in relation to 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 of outstanding practice:

• The practice had identified the needs of diabetic patients and since 2013 had employed a dedicated diabetes specialist nurse.This allowed the practice to deliver diabetic services up to level four which included insulin initiation.In addition, a diabetic consultant attended the practice to review patients. This prevented the need for diabetic patients to attend secondary care unnecessarily. Patient satisfaction with the service was high and in the latest practice survey 97% of patients rated the care received as either excellent or good.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 14 June 2016

The practice is rated as outstanding 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.

• Since 2013 the practice had employed a dedicated diabetes specialist nurse.This allowed the practice to deliver diabetic services up to level four which included insulin and GLP-1 initiation (GLP-1 is a class of injected drugs for the treatment of type 2 diabetes). In addition, a diabetic consultant attended the practice to review patients. This prevented the need for diabetic patients to attend secondary care unnecessarily. Patient satisfaction with the service was high and in the latest practice survey 97% of patients rated the care received as either excellent of good.

• 100% of newly diagnosed diabetic patients had been referred to a structured education programme in the last 12 months, compared to 94% locally and 90% nationally.

• The practice hosted other specialist/enhanced clinics which included physiotherapy, heath trainer advice and prostate cancer screening.

• All patients on long term condition registers were invited for structured reviews on at least an annual basis. During these reviews patients had bespoke care plans developed for them and received advice on how to manage the condition.

• The practice offered e-consultations with secondary care specialist consultants. This meant a reduction in the need for patients to visit secondary care providers, and also meant they received more timely advice and treatment than would be otherwise the case.

• Longer appointments and home visits were available when needed.

• 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.

Updated 14 June 2016

• 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.

• We were told 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’s uptake for the cervical screening programme was 81%, which was comparable to CCG and national averages. The practice had a policy of always following up cervical screening non-responders.

• Appointments were available outside of school hours and the premises were suitable for children and babies. Additionally, extended appointments were available Monday to Friday for new born six to eight week baby checks at any of the practice locations.

• The safeguarding lead GP had weekly meetings with the health visitor team at the Castleford Health Centre branch surgery.

• Sexual health and contraceptive and cervical screening services were provided at the practice.

Updated 14 June 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.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. We were told elderly patients were given additional time and help to book their appointments if they were perceived to be struggling with the booking system.

• The practice delivered an avoiding unplanned admissions service which provided proactive care management for patients who had complex needs and who were at risk of an unplanned hospital admission.

• The practice had recently joined the Wakefield Vanguard Connecting Care programme, part of  which involved the practice providing regular clinical support to 11 nearby residential and nursing homes. The support included meeting individual patient health needs and the development and review of care plans. At the time of inspection the practice was providing services to 151 care home residents, of these residents 84% had active care plans in place.

Updated 14 June 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• Students and young people aged 17 years and above were able to access an enhanced service catch up programme for MMR and Meningitis C vaccinations (MMR vaccine is an immunisation vaccine against measles, mumps, and rubella) .

• 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. For example, the practice provided telephone consultations during the day to patients who may otherwise not be able to attend.

• 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 14 June 2016

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

• The practice has a high dementia diagnosis rate of 84% and at the time of inspection had 153 patients on its dementia register.

• 79% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months; this was comparable to the CCG and national average.

• 92% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive care plan documented in the record, in the preceding 12 months which had been agreed between individuals, their family and/or carers as appropriate. This was 2% above the CCG average and 4% above the national average.

• The practice regularly worked with multidisciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice informed patients experiencing poor mental health how to access various support groups and voluntary organisations. In addition the practice worked with a local provider to offer weekly Improving Access to Psychological Therapies (IAPT) sessions either by referral or self-referral. (IAPT is a programme of talking therapy treatments recommended by the National Institute for Health and Clinical Excellence (NICE) which supports frontline mental health services in treating depression and anxiety disorders).

• Staff had an understanding of how to support patients with mental health needs and dementia.

• The practice was registered under the Wakefield Safer Places Scheme. This was a voluntary scheme which assisted vulnerable people to feel safer and more confident when in the community and away from home settings.

Updated 14 June 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 in vulnerable circumstances including those with a learning disability and the frail elderly.

• Castleford Health Centre branch surgery worked closely with a local homelessness hostel to deliver healthcare services to residents.

• The practice offered longer appointments for patients with a learning disability and for those whose conditions would benefit from a longer consultation period.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients. For example, the practice met with other health and social care professionals including palliative care nurses on a monthly basis to discuss individual cases and update care plans.

• 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.