Archived: Earlsheaton Medical Centre

Updated 1 September 2016

Earlsheaton Medical Centre is the branch practice of Mount Pleasant Medical Centre in Batley. They provide primary care medical services to 14,544 patients under a personal medical services (PMS) contract in Batley and Earlsheaton. The branch surgery is registered with the CQC as a separate location. Patients can be seen at either surgery.

• The practice is located in a two storey property which was purpose built in 1997, next to a pharmacy and close to local shops and schools. All patient services are delivered at ground floor level.
• The practice has a younger than average population. Fifty eight per cent of patients are aged between 0 and 18 compared to the national average of 38%. Sixty eight per cent of patients are from black, minority, ethnic populations. Unemployment is higher at 8% (national average 5%) and 6% of patients receive Disability Living Allowance.
• There are four GP partners, three salaried GPs and a locum GP who works on a regular basis. There are two advanced nurse practitioners, one male and one female; three female practice nurses; a female health care assistant and female apprentice health care assistant; two female phlebotomists, a practice manager and a team of administrative staff.

• The practice is open between 8am and 6.30pm Monday, Tuesday, Thursday and Friday. On Wednesday the practice is open between 8am and 2.30pm, between 2.30pm and 6.30pm telephone calls are transferred to the main surgery in Batley. Extended hours appointments are offered on Mondays until 8.30pm. In the event of a bank holiday, extended hours are offered on Tuesday or Thursday. Appointments can be pre-booked from 8am for working people.

• When the surgery is closed, telephone calls are transferred to Local Care Direct which is the out of hours service provider.
• The practice is a member of North Kirklees CCG, the Batley and Birstall Cluster group of GP practices and Curo Health which is a federation of local GP practices.
• Earlsheaton Medical Centre is not a training practice. However, the advanced nurse practitioner is a mentor for nursing students from the local university.

Updated 1 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Earlsheaton Medical Centre on 15 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 did not always find it easy to make an appointment with a named GP. Urgent appointments were available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice worked with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. For example, the practice was able to offer 24 hour blood pressure monitoring for patients with hypertension.
• 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.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Establish a programme of auditing and monitoring to check that key policies and infection prevention and control (IPC) practices are being implemented appropriately.
• Carry out Control of Substances Hazardous to Health (COSHH) risk assessments.
• Label clinical waste bags in line with current legislation and guidance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 1 September 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.
• 95% of patients newly diagnosed with diabetes, in the preceding 12 months had a record of being referred to a structured education programme within 9 months after entry on to the diabetes register (CCG and national average 90%).
• Longer appointments and home visits were available when needed.
• 24 hour blood pressure monitoring was provided for patients with hypertension.
• 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.
• Patients at high risk of hospital admission who were not under the care of a community matron were referred to a CCG employed Care Co-ordinator who worked with patients to help them manage their conditions. They also liaised with NHS and social care services to ensure patients were supported.
• The practice hosted a local authority employed Health Trainer. Staff could refer or encourage patients to self refer. Health Trainers provide an encouraging and supportive role to adults in Kirklees who have a long term health condition and who want to make positive changes to their lives to improve their health and wellbeing.

Updated 1 September 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.
• Prevalence data showed that 9% of the patient list had asthma (national average 6%). Performance for asthma related indicators was better than the national average. For example, 84% of patients with asthma had an asthma review in the preceding 12 months that included an assessment of asthma control (CCG average 79%, national average 75%).
• 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 practice’s uptake for the cervical screening programme was 89%, which was better than the CCG and national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice offered open access for children with long term and chronic conditions. Children aged under five were offered same day appointments.
• We saw positive examples of joint working with midwives, health visitors and school nurses.
• GPs and nurses carried out family planning and contraceptive services which included coil and contraceptive implant fitting. Nurses provided follow up contraception monitoring for all methods initiated by the GPs.
• The practice carried out ante natal, post natal and six week baby checks.
• The practice hosted a pregnancy termination service on a weekly basis.

Updated 1 September 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.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. Nursing staff reviewed housebound patients at least annually and other patients with urgent needs would be visited by the GP as needed.
• Clinicians visited local nursing homes regularly to provide acute and chronic management.
• Patients over the age of 65 were invited to attend for a seasonal flu vaccination. In 2013/14 75% of patients received their flu vaccination compared with the national average of 73%.
• The practice maintained an avoiding hospital admissions register. Post hospital discharge reviews were carried out for patients on the list.
• The practice offered arthritis care clinics with an arthritis champion. Data showed that 97% of patients with rheumatoid arthritis had a face-to-face annual review in the preceding 12 months (CCG average 90%, national average 91%).
• Atrial fibrillation screening was offered to all patients over the age of 50. Atrial fibrillation is a heart condition which causes an irregular and often abnormally fast heart rate.
• Abdominal aortic aneurysm screening was offered to male patients over the age of 65 years. An abdominal aortic aneurysm is a balloon-like swelling in the wall of the aorta within the abdomen which may rupture.
• Patients at high risk of hospital admission who were not under the care of a community matron were referred to a CCG employed Care Co-ordinator who liaised with NHS and social care services to ensure patients were supported.
• The practice offered Prostap injections for patients with prostate cancer. Prostap is a type of hormone therapy treatment for prostate cancer.

Updated 1 September 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 reflects the needs for this age group.
• Extended hours appointments were offered on Mondays until 8.30pm. In the event of a bank holiday, extended hours were offered on Tuesday or Thursday.
• The practice offered telephone consultations for patients who were unable to attend the surgery.

Updated 1 September 2016

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

• 78% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is lower than the national average of 84%.
• 86% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive care plan documented in the record, in the preceding 12 months (CCG and national average 88%).
• The practice referred patients taking benzodiazepines to the North Kirklees Clarity project which provides a structured programme to reduce the overall prescribing of these medicines. Benzodiazipines are used to treat anxiety and sleeping problems.
• 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. Staff had received dementia friends training to understand the needs of dementia patients and their carers.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• 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 1 September 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.
• 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.
• Clinical staff carried out alcohol brief intervention advice. They used AUDIT-C which is a recognised screening tool that can help identify persons who are hazardous drinkers or have active alcohol use disorders.