The Spa Surgery

Updated 4 July 2016

The Spa Surgery is a purpose built surgery in the centre of Harrogate. The building is shared with two other GP practices. The Spa practice provides General Medical Services to approximately 15,000 patients living in Harrogate, Killinghall and Pannal.

The practice is a training practice and trains GP registrars and Foundation Year 2 doctors. It also teaches undergraduate medical students.

The practice has 10 GP partners, two salaried GPs and two trainee GPs. There are four male and 10 female GPs. The practice has five practice nurses, two healthcare assistants and a pharmacist. They are supported by a team of management, reception and administrative staff.

The practice is in an affluent area and has a lower than average proportion of its population who are classed as deprived. It also has a higher than average number of patients who are over 75.

The practice provides appointments between 8.00am and 6.00pm on a Monday and Friday and between 7.30am and 7.00pm on a Tuesday, Wednesday and Thursday. Out of Hours services are provided by Harrogate Hospital GP Service and are accessed through the 111 telephone number.

The practice also offers enhanced services including childhood vaccination and immunisation scheme, extended opening hours, support for people with dementia, influenza and pneumococcal immunisations, minor surgery and unplanned admissions.

Updated 4 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Spa Surgery on 23 March 2016. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• 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.
• Information about services and how to complain was available and easy to understand.
• Patients said they 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.
• The practice worked with the local boarding school to provide School Doctor services and education and support on contraception.
• 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 4 July 2016

The practice is rated as good for the care of people with long-term conditions. Nationally reported data for 2014/2015 showed that the practices performance across a range of diabetes related indicators was similar to the national average. The GPs had knowledge in specific clinical area, such as dementia or palliative care and shared good practice with clinical colleagues. Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All of these patients had a named GP and a structured annual review to check that their health and medication needs were being met. The practice had put in place a robust recall system to ensure that patients requiring a review were not missed. For those people with the most complex needs, the named GP worked with relevant health and social care professionals to deliver a multidisciplinary package of care. These patients also had access to the practice pharmacist (by telephone or appointment) to discuss their medications. The practice offered additional support to patients had just been placed on insulin by calling them over the weekend to ensure that they were able to manage their new medication effectively.

Updated 4 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 in line with national averages for standard childhood immunisations. Children and young people were treated in an age-appropriate way and were recognised as individuals. Appointments were available outside of school hours and the premises were suitable for children and babies. There was joint working with midwives, health visitors and school nurses. The practice also facilitated visits to the practice from children at the local primary school so that they could meet the GPs and nurses. Nationally reported data for 2014/2015 showed that the practice was in line with the national averages for rates of cervical screening. 75% of patients diagnosed with asthma, on the register, had had an asthma review in the last 12 months; this was comparable to the national average of 75%. The practice worked with the local boarding school to provide School Doctor services and education and support on contraception.

Updated 4 July 2016

The practice is rated as good for the care of older people. Nationally reported data for 2014/2015 showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia. They were responsive to the needs of older people and offered home visits and rapid access appointments for those with enhanced needs. The practice worked with nine other local practices to enhance the care of patients in Care homes. The GPs visited five local care homes each week to review patients. They also provided a priority telephone number for staff at the care homes to use. A local carers association ran fortnightly drop in sessions for carers. Two direct dial telephone lines were available in the reception area so that patients could easily call for a taxi.

Updated 4 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. 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. The practice offered evening cervical smear and contraceptive clinics.

Updated 4 July 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Nationally reported date from 2014/2015 showed 79% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months. Overall the practice performance across a range of mental health related indicators was comparable to the national averages. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. The practice told patients experiencing poor mental health how to access support groups and voluntary organisations. The practice provided same day appointments for patients who may be experiencing poor mental health. Staff had a good understanding of how to support patients with mental health needs and dementia. The medicines management team checked every four weeks for prescriptions which had not been collected and the relevant GP was told and would follow up.

Updated 4 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 including 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. There was monthly meeting between the practice safeguarding lead and health visitors. The practice also had a named administrator who processed safeguarding information.