Dr Leaver & Partners Also known as Drs Leaver, O'Shea, Lambert and Shahzadi (Harper)

Updated 22 June 2016

Jericho Health Centre – Bogdanor, also known as Dr Leaver & Partners, provides GP services to about 7,000 patients in Oxford city centre. Just fewer than half its patients are university students, but it also services a highly mobile population of short term occupancy tenants, many from Eastern Europe, and a more static population of local homeowners. It experiences a considerable turnover on its patient list annually, with 3,168 new patients registered in the last 12 months. The practice has significantly more patients aged 15 to 34 than the national average and considerably fewer children and adults aged 35 and over.

The practice has four GP partners, two female and two male, equivalent to three whole time GPs. There is one practice nurse and one healthcare assistant, equivalent to 1.3 whole time nursing care, along with a practice manager and a team of administration and reception staff. The practice is approved to offer teaching and training. It supports qualified doctors who are seeking to become GPs and offers placements for medical students. It is the named practice for five university colleges and three halls of residence. It has close links to college nurses in the colleges it serves, and the senior GP partner is the secretary of the College Doctors Association. The practice has an attached psychologist and counsellor who can see patients at the practice.

The practice is based at Jericho Health Centre in a building owned by the University and leased by the NHS. The health centre houses another GP practice and a number of health services which share a central patient waiting area on the ground floor of the building. The building has designated disabled parking spaces and ramp access. The practice has five consulting rooms, one nurse’s room and a treatment room for minor operations. The health centre has assisted access WC facilities and baby changing facilities. Both are accessible from the main shared waiting area.

The practice is open from 8.30am to 6pm Monday to Friday, with appointments available between 8.30am and 10.30am, 11pm and 12pm, and between 2.30pm to 5.30pm.The practice offers extended hours on Thursdays until 8.30pm. The practice has opted out of providing out of hours services to their patients. The out of hours service is provided by Primary Medical Limited, and is accessed by calling the NHS 111 telephone number. The practice provides duty GP telephone cover from 8am and from 6pm to 6.30pm via a call handling service for the times when the out of hours service is closed.

Updated 22 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Jericho Health Centre – Bogdanor on 27 April 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 of outstanding practice:

The practice had identified from new patient registrations that it had a number of young families on its list who were newly arrived in the UK with little support available. The practice had set up a scheme to provide information and support to these patients, including promoting the university newcomers club to the families of students and staff how have moved from abroad, and linking university medical students, who are DBS checked and trained in paediatric life support, with these families to provide babysitting services. This supports these families in settling into their new family life in Oxford.

The areas where the provider should make improvements are:

• Work to improve areas of patient outcome where they are below the national and CCG average, by ensuring that patients who are not attending appointments for cancer screening or to manage long term conditions are given wider opportunities to engage with health care provision.

• Work to improve childhood immunisation rates for patients aged up to 24 months.

• . Work to promote extended hour availability to patients, and regularly review patient satisfaction with the practice’s opening hours.

• Continue to work with the patient participation group to identify and provide improvements to the service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 June 2016

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.

• Diabetes management indicators were comparable to national averages, with 100% of patients with diabetes receiving flu immunisation over the last winter, compared to a CCG average of 96% and a national average of 94%.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 was working with the CCG to develop and pilot a digital proactive care planning template to support patients in managing long term conditions to reduce unplanned hospital admissions and improve communication with out of hours services.

• The practice was liaising with university colleges to improve support for students with diabetes.

Updated 22 June 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 patients who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.

• Patients told us that children and young patients were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

Fifty three per cent of female patients aged 25 to 64 had attended for cervical screening within the target period, compared to a national average of 74%. The practice had identified issues regarding screening attendance, and were considering strategies to address it.

• 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 practice linked DBS-checked university medical students with families newly arrived in the UK to provide support such as babysitting services. It also provided information to these families about local services such as health visitor support and baby clinics and social events.

Updated 22 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 patients in its population.

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

• The practice allocated a number of same-day appointments to allow older patients to see their usual GP for continuity of care, and prioritised them for telephone consultations.

• The practice was working with the CCG in developing and piloting designing new digital care plans as part of a project to reduce unplanned hospital admissions and to provide out of hours services with information on patients’ care preferences and end-of-life plans.

• The practice made regular use of the Oxfordshire Single Point of Access system and local care navigator to support older patients in accessing community services.

Updated 22 June 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 reflects the needs for this age group.

• Extended surgery was held on one evening a week until 8.30pm, and telephone consultations were available for those who found it difficult to attend during the working day.

• University students could register with the practice via a website portal, and the practice had close relationships with the nurses and welfare staff at its attached colleges, attending termly meetings to discuss service and support. The practice was also actively involved in shaping university welfare policy through attendance of university meetings.

• The practice actively promoted screening for the sexually transmitted disease chlamydia among its patients aged 16 to 24.

Updated 22 June 2016

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

• However, 56% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the preceding 12 months, compared to the national average of 88%. The practice had identified that its mental health care plan reviews had previously been incorrectly coded, and was addressing this to improve its figures.

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

• 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, through referrals the local care navigator and direct signposting to support groups and voluntary organisations

• The practice had incorporated a dementia assessment into its NHS health checks for over 65s.

• The practice proactively followed up patients experiencing mental health problems who had attended hospital accident and emergency departments.

Updated 22 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 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

• The practice had identified from new patient registrations that it had a number of young families on its list who were newly arrived in the UK with little support available. The practice had set up a scheme to link university medical students with these families to provide support, such as free babysitting services.