The Beckside Centre

Updated 21 July 2016

Pocklington Group Practice provides a General Medical Service (GMS) to their practice population of 15,617patients. They are also contracted to provide other enhanced services for example: extended hours access and minor surgery. They have a modern purpose built (in 2015) GP practice on the outskirts of Pocklington. Their practice population comes from the town and from surrounding villages and farm lands. There is a contract to provide transport for patients who may have had difficulties getting to the new building. The contract will end in August/ September and the practice is looking at ways to continue this service. There is a car park with parent and child spaces as well as disabled parking.

There are eight GP partners (4 female and 4 male). There are three salaried GPs (2 female and one male).There is one Managing Partner who is supported by five senior managers. This is a teaching and training practice. The medical students are from Hull & York Medical School.   In addition there are places for qualified doctors who wish to train as GPs. There is currently one GP registrar from the York Vocational Training Scheme (male). There are four female practice nurses, two female Advanced Nurse Practitioners and three female healthcare assistants and a phlebotomist. There are 27 clerical and administrative support staff that support the clinical staff; their roles included receptionists, dispensers, and secretaries.

The practice is open Monday to Friday from 8am until 6pm for reception and dispensary services. There is a minor injury service Monday to Friday from 8am until 6pm for assessment and treatment; this is available to practice patients and people who are visiting the area. The telephones are answered Monday to Friday from 8am until 12.15pm and from 1.15pm until 6pm. On the first Wednesday of each month the practice is closed for staff training from 1pm until 2.15pm. At this time the practice is covered for emergencies by the practice duty team. Every Saturday morning the practice is open from 8am to12midday for pre-booked appointments only; for those patients requiring emergency treatment at this time they are advised to contact NHS 111.

Updated 21 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Pocklington Group Practice on 14 June 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 each 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 their management team. 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. The partners encouraged a culture of openness and honesty.

We saw an area of outstanding practice:

• Pocklington Integrated Health and Social Care Hub which was launched in December 2014 looked at new ways of working and supporting their older patients. Its focus was to provide better, co-ordinated care to patients most at risk of hospital admission. We were provided with compelling evidence showing how appropriate treatment and support had decreased the non-elective admissions (NEA) to secondary care (hospital) for 65 years + by 12% and an overall decrease for all age groups (NEA) of 5%. There was a 10% decrease of secondary care bed occupation in comparison to previous years.

There were areas of practice where the provider needs to make improvements,the provider should:

• Review procedures to ensure all repeat prescriptions are signed before being dispensed to patients.
• Rationalise the arrangements for the management of patient group directions.

• Review the storage of controlled drugs to ensure they meet with legislative requirements.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 July 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. All patients had care plans in place.

• The percentage of patients with diabetes, on the register, in whom the last IFCC-HbA1c was 64 mmol/mol or less in the preceding 12 months (01/04/2014 to 31/03/2015), was 83% which was similar to the CCG average of 82% and higher than the national average of 77%.

• The percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) was 140/80 mmHg or less (01/04/2014 to 31/03/2015) was 64% which was lower than the CCG average of 77%and the national average of 78%.

• The percentage of patients with diabetes, on the register, who had had influenza immunisation in the preceding 1 April to 31 March (01/04/2014 to 31/03/2015) was 95% compared to the CCG average of 96% and the 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.

Updated 21 July 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 who had a high number of A&E attendances. Immunisation rates were high for all standard childhood immunisations.

• 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 percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed in the preceding 5 years (01/04/2014 to 31/03/2015) was 78% which was lower than the CCG average of 81% and lower than the national average of 82%. 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.

Updated 21 July 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. All patients over the age of 75 had an accountable GP.

• There were care plans for patients over the age of 75 and those at high risk of hospital admission.

• Pocklington Integrated Health and Social Care Hub which was launched in December 2014 looked at new ways of working and supporting their older patients. Its focus was to provide better, co-ordinated care to patients most at risk of hospital admission. There was compelling evidence showing how appropriate treatment and support had decreased the non-elective admissions (NEA) to secondary care (hospital) for 65 years + by 12% and an overall decrease for all age groups (NEA) of 5%. There was a 10% decrease of secondary care bed occupation in comparison to previous years.

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

• A care of the elderly consultant held a clinic in the practice each month.

Updated 21 July 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.

• This included a range of appointment lengths, times, and formats with extended hours sessions of pre-bookable appointments each Saturday morning. Two GPs provided these sessions. In addition there were appointments before work, telephone appointments and email consultations readily available.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs of this age group.

Updated 21 July 2016

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

• 77% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was lower than the CCG average of 85% and also lower than the national average of 84%.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months (01/04/2014 to 31/03/2015) was 73% which was lower than the CCG average of 92% and lower than the national average of 88%.
• 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 how to access various support groups and voluntary organisations.
• The ‘duty doctor’ service for urgent issues with face to face and telephone appointments available allowed staff to prioritise management of patients in mental health crisis.
• 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.

Updated 21 July 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 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.