Archived: The Health Care Surgery

Updated 14 December 2017

The Health Care Surgery is located at 63 Palgrave Road, Sheffield, S5 8GS and provides an extended access primary medical care service as one of four satellite Hubs for 580,000 patients living in the Sheffield area. It also provides access to primary care to patients not resident in Sheffield who contact the NHS 111 service during out of hours periods.

The service is provided by Primary Care Sheffield Limited who have three other locations registered with Care Quality Commission as satellite Hubs: 

• The Crookes Practice, 203 School Road, Sheffield, S10 1GN
• Woodhouse Health Centre, 5-7 Skelton Lane, Sheffield S13 7LY 
• Sloan Medical Centre, 2 Little London Road, Sheffield, S8 0YH 

The provider is contracted by the local clinical commissioning group (CCG) to offer a range of urgent and routine primary medical services through the four satellite Hubs on weekday evenings and at the weekends. The services available include: urgent appointments with a GP, physiotherapy appointments for musculoskeletal problems and practice nurse and healthcare assistant appointments for the following routine services:, removal of sutures, dressing changes, asthma reviews, ear syringing, cervical cytology, blood pressure checks and blood tests. The service is open seven days a week (including bank holidays) from 6pm to 10pm Monday to Friday and 10am to 6pm at weekends. The average number of patients seen a week at this Hub is 150 with 33,628 appointments being utilised across the four Hub sites in the last 12 months. Patients can arrange an appointment either through their usual GP or by contacting the NHS 111 service when their own GP practice is closed. Patients may be seen by a GP, practice nurse, physiotherapist or healthcare assistant depending on their needs. The service is provided by existing Sheffield GPs and practice nurses who have an agreement with Primary Care Sheffield Limited to provide GP and practice nurse sessions in the Hubs. The provider employs physiotherapists and healthcare assistants. There is a Hub manager at each site who is supported by a team of reception staff.

Updated 14 December 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Health Care Surgery, which is one of the four Extended Access Hub sites across Sheffield, on 23 October 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, recording and actioning significant events. However, it was not evident how lessons learned from significant events were disseminated and shared with staff working across the Hub sites.

• The service 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.

• CQC comment cards and the NHS friends and family survey data showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.

• Patients we spoke with were very satisfied with the availability and timeliness of their appointments.

• Improvements were made to the quality of care as a result of complaints and concerns.

• The premises 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 service sought feedback from patients, which it acted on.

We saw one area of outstanding practice:

• The service offered physiotherapy appointments. Patients could book directly into these appointments via their own GP practice. Provider data between July and September 2017 showed that 90% of patients seen with joint pain had required only one appointment for self management advice. The physiotherapist could refer patients directly through the local musculoskeletal pathway if appropriate.

The areas where the provider should make improvement are:

• Review how learning and development from significant events and complaints could be fedback and shared to staff working across the four Hub sites.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 14 December 2017

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

• Patients with long-term conditions would be monitored and managed by their usual GP. However, the service offered supplement appointments for some long-term conditions, for example, asthma to improve the monitoring and management of these conditions by offering access in the evening and at weekends.

• Nursing staff had lead roles in offering asthma reviews and had a plan to start undertaking diabetic reviews in the near future and staff were currently being recruited for this. Patients’ care plans were updated to reflect any additional needs.

Updated 14 December 2017

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

• Patients told us, on the day of inspection, that children and young people were treated in an age-appropriate way and were recognised as individuals.

• The premises were suitable for children and babies. Monitoring data undertaken by the provider indicated that 28.5% of attendees at the Hub sites were under the age of 15.

• Arrangements were in place to safeguard children from abuse. These arrangements reflected relevant legislation and local requirements. Policies were accessible to all staff and outlined who to contact for further guidance. There was a lead GP for safeguarding and all staff had received training on safeguarding children relevant to their role.

• The service provided cervical cytology for patients who could not attend during the working day.

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

Updated 14 December 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 service was not commissioned to provide home visits as this service was offered by the Sheffield GP out of hours service.

• Where older patients had complex needs, the practice shared summary care records with local care services as appropriate.

• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible.

Updated 14 December 2017

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

• The service operated evenings and weekends 52 weeks a year to provide patients who could not attend an appointment during the day choice and flexibility when booking an appointment. The service offered continuity of care as consultations were recorded directly into the patients’ medical record.

• The service offered urgent same day appointments to see a GP and access to nurses and healthcare assistants for routine care, for example blood tests, ear syringing, blood pressure checks, removal of sutures and dressing changes. The service also offered first contact appointments with a physiotherapist for musculoskeletal problems, for example, joint pain. The service had audited this and data showed that 90% of patients seen with joint pain were dealt with at the first appointment.

Updated 14 December 2017

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

• The service had considered the physical health needs of patients with poor mental health. For example the service was in the process of developing its skill mix to respond to mental health needs across the locality by providing a primary mental health appointment for those who could not attend their own general practice during working hours.

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

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

Updated 14 December 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice offered longer appointments for all patients.

• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.

• Staff interviewed 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 when required.