Archived: Southowram Surgery

Updated 22 June 2017

Southowram Surgery is situated at Law Lane, Southowram, Halifax HX3 9QB. There are currently 2,911 patients registered on the practice list. The practice provides Personal Medical Services (PMS) under a locally agreed contract with NHS England.

The Public Health National General Practice Profile shows the majority of the practice population to be of white British origin, with around 2% of the practice originating from mixed or Asian origin. The level of deprivation within the practice population group is rated as seven, on a scale of one to ten. Level one represents the highest level of deprivation, and level ten the lowest.

The age/sex profile of the practice is in line with national averages. The average life expectancy for patients at the practice is 78 years for men and 84 years for women; compared to the CCG averages of 77 and 82 years respectively; and the national averages of 79 and 83 years respectively.

58% of the practice population has a long standing health condition, compared to the CCG and national average of 53%; 68% of the population are in full or part time work compared to the CCG average of 61% and the national average of 63%.

The practice offers a range of enhanced services which include childhood vaccination and immunisation, influenza and pneumococcal immunisations, extended hours access and minor surgical procedures.

The practice has two GP partners, one male and one female. The clinical team is completed by a female practice nurse and female health care assistant (HCA). Supporting the clinical team is a practice manager and a range of reception and administrative staff.

The practice is open between 8.30am and 8pm on Monday, and between 8.30am and 6.30pm Tuesday to Friday. The practice is housed within single storey purpose built accommodation. There are a limited number of car parking spaces available on site; however on-street parking is also available. The premises are accessible to patients with limited mobility; or those patients who use a wheelchair.

Out of hours care is provided by Local Care Direct which is accessed by calling the surgery telephone number, or by calling the NHS111service.

Updated 22 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Southowram Surgery on 9 May 2017. 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 a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey were consistently high, and showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patient satisfaction with regards to access to appointments was consistently high. One of the GPs had led on a CCG practice access incentive scheme which aimed to improve patient access to appointments in line with Royal College of General Practitioner (RCGP) guidelines.
• The practice demonstrated they had increased uptake of bowel screening by 12% in 2016 by sending a personal letter signed by their named GP to patients to encourage uptake of this service.
• 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 the GP partners and practice manager. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider should make improvement are:

• Update practice policies in a timely way.

• Consider reviewing staff immunity to Measles, Mumps and Rubella (MMR) in line with Public Health England guidelines.

• Regularly review and update risk assessments in relation to emergency medicines held on site.

• Include Parliamentary and Health Services Ombudsman details when replying to patient complaints.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 June 2017

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

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

• 82% of patients with diabetes, on the register, had a cholesterol reading which was within normal limits recorded in the preceding 12 months compared to the CCG average of 81% and the national average of 80%.

• The practice provided a level three diabetic service in-house. This enabled those patients whose diabetes was stable, and controlled by insulin, to be monitored and treated in the practice. Support for this service was offered by diabetes specialist nurses from the CCG.

• Patients with long term conditions received ongoing monitoring and support as necessary. Additional support was provided if any deterioration in health occurred.

• All these patients had a named GP and there was a system to recall patients for 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

Updated 22 June 2017

The practice is rated as good for the care of families, children and young people.

• From discussion with staff we found there were systems 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.

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

• The practice hosted a weekly health visitor clinic. Informal liaison to support families occurred at this time. In addition monthly multidisciplinary meetings were held where families identified as having additional needs were discussed and care plans updated.

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

• The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications.

Updated 22 June 2017

The practice is rated as good for the care of older people.

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.

• 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 identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care. Quarterly palliative care meetings were held.

• The practice followed up on older patients discharged from hospital, liaised with district nurses, and ensured that their care plans were updated to reflect any extra needs.

• Where older patients had complex needs, the practice shared summary care records with local care services, for example out of hours services.

• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible. The practice promoted the ‘Southowram Over Fifties Association’ (SOFA) which provided social activities and support for older people.

• Practice staff had received ‘Dementia Friendly’ training.

Updated 22 June 2017

• The needs of these populations 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 open until 8pm on Monday to provide access to appointments outside normal working hours.

• A text messaging service was provided reminding patients of appointment times.

• 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. We saw that 568 patients (19% of the patient group) had registered for online access.

Updated 22 June 2017

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

• The practice had participated in developing guidance for general practitioners in the local area, in relation to the death of patients who were subject to Deprivation of Liberty Safeguards (DOLS).

• 100% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was higher than the CCG average of 82% and the national average of 84%.

• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.

• 94% of patients with schizophrenia or other psychoses had a comprehensive care plan completed and agreed in the preceding 12 months which was higher than the CCG average of 90% and the national average of 89%.

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

• Patients at risk of dementia were identified and offered an assessment.

• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.

• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia. All staff had received ‘Dementia Friends’ training.

Updated 22 June 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 those with a learning disability.

• A monthly search was run to identify vulnerable patients, and decisions were made in regard to any changes to their care and support which were required.

• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.

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

• The practice worked with other health care professionals in the case management of vulnerable patients.

• The practice provided information for vulnerable patients on accessing appropriate support groups and voluntary organisations.

• Staff we spoke with demonstrated they knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.