Archived: Queen Street Surgery

Updated 3 June 2016

The Queen Street Surgery is located in a mixed residential and commercial area of Normanton, West Yorkshire. The practice currently provides services for around 2,400 patients. The surgery is located in a three storey purpose built building which it shares with an independent healthcare organisation. The practice occupies the ground floor and part of the first floor and has been operating at the site since 2005. The surgery has parking to the front of the building and additional parking is available on nearby street should this be required. The surgery has easy access for those with a disability.

After a long period of low staff turnover the practice has recently experienced some changes including the retirement of an existing GP partner and their replacement with an advanced nurse practitioner. From April 2016 the senior GP partner will also be retiring to be replaced by a new GP partner, this will also be accompanied by some changes in surgery management and operation. The practice is a member of the NHS Wakefield Clinical Commissioning Group (CCG.)

The practice population age profile shows that it is slightly above the England average for those over 65 years old (23% compared to a CCG average of 18% and an England average of 17%). The practice population is predominantly White British in composition.

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

• Diagnosis and support for people with dementia

• Influenza and Pneumococcal immunisation

• Rotavirus and Shingles immunisation

• Minor surgery

• Risk profiling and care management

• Unplanned admissions

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 menopause and osteoporosis.

Attached to the practice or closely working with the practice is a varied team of community health professionals including health visitors, midwives, community nurses and the local health and wellbeing team (offering community support and advice via referral or self-referral).

The practice has two GP partners (male) and one advanced nurse practitioner partner (female). In addition there is one practice nurse and one healthcare assistant /receptionist (both female). Clinical staff are supported by a practice manager, an administration/reception team and a cleaner.

The practice offers a range of appointments and consultations, these include:

• Pre-bookable appointments – up to 12 weeks in advance.

• Urgent and emergency appointments.

• Telephone consultations with a GP or advanced nurse practitioner. After the initial call the practice will ring the patient at an agreed time to discuss their condition.

The practice is open Monday to Friday 8am to 6.30pm. Clinical appointments are available:

• Monday 8.50am to 11am and 3pm to 5.30pm.

• Tuesday 8.50am to 11am and 3pm to 5.30pm.

• Wednesday 8.50am to 11.00am.

• Thursday 8.50am to 11am and 3pm to 5.30pm.

• Friday 8.50am to 11am and 3pm to 5.30pm.

Home visits are also available.

Appointments can be made in person, on the 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 3 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Queen Street Surgery on 14 and 15 March 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• The provider was aware of and complied with the requirements of the Duty of Candour (being open and transparent with people who use the service, in relation to care and treatment provided). This was reflected in their open, honest and transparent approach to safety. All staff were encouraged and supported to report and record any such incidents. There was evidence of investigation, and learning and sharing mechanisms were in place.
• Risks to patients were assessed and well managed and policies and procedures had been developed to support effective management and governance.
• 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. Staff had received additional training with regard to learning disabilities and dementia to enable them to better support these specific patient groups.
• Information regarding the services provided by the practice was available for patients.
• There was a complaints policy and clear information available for patients who wished to make a complaint.
• Patients said they generally found it easy to make an appointment with a named GP and that 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 a stable workforce in place. Staff were aware of their roles and responsibilities and told us the GPs and manager were accessible and supportive. The practice promoted an all-inclusive approach amongst staff.

• The practice sought patient views how improvements could be made to the service, through the use of patient surveys, the NHS Friends and Family Test and the patient participation group.

We saw some areas where the provider should make improvements:

• The practice should ensure that proof of identification checks are carried out and recorded in relation to all newly recruited staff.

• The practice should ensure that all clinical equipment is regularly checked to determine that it is within date and suitable for use.
• The practice needed to review and update its records in relation to the immunity and vaccination status of its staff to ensure that these were up to date.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 June 2016

The practice is rated as good for the care of people with long-term conditions.

• The practice provided nurse led clinics for conditions which included diabetes, asthma, chronic obstructive pulmonary disease (COPD) and coronary Heart disease (CHD).

• Patients at risk of hospital admission were identified as a priority as part of the practice’s unplanned admissions avoidance service.

• Longer appointments and home visits were available when needed.

• Patients had a named GP and a structured annual review to check their health and medicines needs were being met.

• Almost 65% of patients with three or more long term conditions had a care plan in place that was reviewed annually.

• For those patients with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care. For example, the practice held monthly multidisciplinary meetings with community nurses, palliative care nurses, and health and wellbeing advisors where the needs of specific patients were discussed and care packages were reviewed.

• The practice had a dedicated mobile telephone line available for patients with long term conditions. Patients are told that they can ring weekdays 8am to 6.30pm, bypassing the main switchboard if they had concerns regarding their condition.

Updated 3 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 people for whom there were safeguarding concerns.

• Immunisation rates were high for all standard childhood immunisations, achieving 100% for many vaccinations.

• 80% of patients with asthma, on the register, had received a review in the preceding 12 months compared to a national average of 75%.

• We were told that children and young people were treated in an age-appropriate way and were recognised as individuals.

• Sexual health, contraceptive and cervical screening services were provided and the practice participated in the c-card scheme which gave young people access to contraceptives.

• 83% of women aged 25-64 had on record that a cervical screening test had been carried out in the preceding five years compared to a national average of 82%.

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

• The practice held monthly meetings with health visitors to discuss safeguarding concerns.

Updated 3 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.

• The practice delivered an unplanned admissions avoidance service which provided proactive care management for patients who had complex needs and were at risk of an unplanned hospital admission. The practice  carried out advanced care planning and regular patient reviews, which involved multi-disciplinary working across health and social care providers. The register of patients in this cohort was reviewed on a monthly basis at practice meetings.

• The practice had achieved a high uptake for flu vaccination (84%) for this group of patients.

• The practice helped to develop and had supported guided health walks in the local area.

Updated 3 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. For example, well-person screening appointments were available on request.

• 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.

• The practice hosted specialist services which included health trainers, audiology, physiotherapy and abdominal aortic aneurysm screening.

Updated 3 June 2016

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

• 88% of patients diagnosed with dementia who had had their care reviewed in a face to face meeting in the last 12 months, which compared favourably when compared to the national average of 84%.

• 100% of patients who had a severe mental health problem had received an annual review in the past 12 months and had a comprehensive, agreed care plan documented in their record. This was higher than the national 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 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.

• Staff had a good understanding of how to support patients with mental health needs and dementia and the practice had been accredited as ’dementia friendly’.

Updated 3 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 which included those with a learning disability

• The practice offered longer appointments for patients with a learning disability

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

• 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 was accredited as part of the Wakefield Safer Places Scheme. This offered a place of safety and support to vulnerable people when in the community and away from home. For example, should a vulnerable person present themselves at the practice in a distressed or confused state the practice would endeavour to assist and support them.