Archived: Dr S G Hussain Also known as Wilberforce Health Centre

Updated 3 March 2016

The Wilberforce Surgery is situated in the centre of Kinston upon Hull and provides services under a General Medical Services (GMS) contract with NHS England, Hull Area Team to the practice population of 2,380, covering patients of all ages.

The practice has two GP partners, one male and one female. There is one practice nurse and one health care assistant. There is a practice manager, a reception manager and a team of secretarial, administration and reception staff.

The practice is open between 7.15am to 6.30pm Monday to Friday. Appointments are from 8.15am to 5.50pm daily. The practice, along with all other practices in the Hull CCG area have a contractual agreement for NHS 111 service to provide OOHs services (OOHs) from 6.30pm. This has been agreed with the NHS England area team.

The proportion of the practice population in the 65 years and over age group is lower than the England average. The practice population in the under 18 age group is lower than the England average. The practice scored one on the deprivation measurement scale, which is the lowest deprived. People living in more deprived areas tend to have a greater need for health services. The overall practice deprivation score is higher than the England average, the practice is 50.2 and the England average is 23.6.

The practice has opted out of providing out of hours services (OOHs) for their patients. Information for patients requiring urgent medical attention out of hours is available in the waiting area, in the practice information leaflet and on the practice website.

Updated 3 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr S G Hussain (The Wilberforce Surgery) on 10 November 2015. Overall the practice is rated as requires improvement.

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. However, reviews and investigations were not thorough enough. People did not always receive a verbal and written apology.
• Risks to patients were assessed and well managed, with the exception of those relating to recruitment checks.
• Data showed patient outcomes were low for the locality. Although some audits had been carried out, we saw no evidence that audits were driving improvement in performance to improve patient outcomes.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice had a number of policies and procedures to govern activity, but some were overdue for review.
• The practice had good facilities and was well equipped to treat patients and meet their needs.

• 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 areas where the provider must make improvements are:

• Incident reporting must be implemented and incidents formally documented with learning recorded with clear action dates, including a system for analysing and monitoring trends.

• Clinical audits completed must include a full cycle of events to ensure patient outcomes are improved and reflection and learning is recorded with action points identified.

• Ensure recruitment arrangements include all necessary employment checks for all staff.

• Infection control and hand washing audits should be completed and up to date.

In addition the provider should:

• Have systems in place for identifying and monitoring the completion of training and appraisals for all staff in order for them to carry out their duties effectively and safely.

• Have an Induction programme that is clear and follows specific guidelines for all new starters and locum GPs joining the practice.

We saw one area of outstanding practice;

• The practice contracted a dedicated recovery case manager to review specific substance and alcohol misuse cases with patients. This was well managed and communication with the practice and patient records were excellent. Clear tasks and record management were completed in a timely and precise way and this was supported by good team working.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 March 2016

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

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

• Nationally reported data for 2014/2015 showed that outcomes for patients with long term conditions were generally good. However, for example, performance for diabetes related indicators was 72.1%, this was below the local CCG and national average.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 3 March 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 relatively 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.

• Nationally reported data from 2014/2015 showed the practice’s uptake for the cervical screening programme was 80.0%, which was 18.6% below the local CCG average and 17.6% below the national average.

Updated 3 March 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. Patients over the age of 75 had a named GP.

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

• Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people.

Updated 3 March 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 for this age group.

Updated 3 March 2016

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

• Nationally reported data from 2014/2015 showed 62.5% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months. This was comparable to other practices.

• Nationally reported data from 2014/2015 showed the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive care plan documented in their record, in the preceding 12 months was 79.6%. This was comparable to other practices.

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

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• It 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 people with mental health needs and dementia.

• Alcohol counselling, behaviour therapy and substance misuse services were all available at the practice.

Updated 3 March 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 homeless people, travellers and those with a learning disability.

• It offered longer appointments for people with a learning disability.

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

• It had told 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.