New Southgate Surgery

Updated 9 August 2016

The practice surgery is located on Buxton Road in Wakefield, West Yorkshire. The practice serves a patient population of around 12,000; it is a member of NHS Wakefield Clinical Commissioning Group.

The surgery is located in purpose built premises which opened in 1999. The building is accessible for those with a disability and has been adapted further to meet the needs of patients, for example a hearing loop had been installed for those with a hearing impairment. There is parking available nearby for patients and an independent pharmacy is located adjacent to the practice.

The practice population age profile shows that it is slightly above both the CCG and England averages for those over 65 years old (19% compared to the CCG average of 18% and England average of 17%). Average life expectancy for the practice population is 77 years for males and 81 years for females (CCG average is 77 years and 81 years and the England average is 79 years and 83 years respectively). The practice serves a relatively affluent area although there are pockets of deprivation within the practice boundary area. The practice population is predominantly White British.

The practice provides services under the terms of the General Medical Services (GMS) contract. In addition the practice offers a range of enhanced local services including those in relation to:

• Childhood vaccination and immunisation

• Influenza and Pneumococcal immunisation

• Rotavirus and Shingles immunisation

• Support to reduce unplanned admissions.

• Minor surgery

• Extended hours access

• Patient participation

As well as these enhanced services the practice also offers additional services such as those supporting long term conditions management including asthma, chronic obstructive pulmonary disease, diabetes, heart disease and hypertension, and healthy lifestyle advice.

Attached to the practice or closely working with the practice is a team of community health professionals that includes health visitors, midwives, members of the district nursing team and health trainers.

The practice has six GP partners (three male, three female) and two salaried GPs (one male, one female) also at the time of inspection two GP registrars were receiving training within the practice. In addition there are three practice nurses, one healthcare assistant and a phlebotomist (all female). Clinical staff are supported by a practice manager, an administration manager, and an administration and reception team. Via the Wakefield Vanguard programme the practice also has the services of pharmacists and a physiotherapist available in-house.

The practice appointments include:

• Pre-bookable appointments

• On the day/urgent appointments

• Telephone appointments/consultations where patients could speak to a clinician to ask advice and if identified obtain an urgent appointment.

Appointments can be made in person, via telephone or online.

The practice is open between 8am and 6.30pm Monday to Friday. The Practice offers one early morning appointment session on a Wednesday or Thursday 7am to 8am and two evening appointment sessions 6.30pm to 8pm on a Monday and Tuesday.

The practice is accredited as a training practice and supports GP registrars and medical students.

Out of hours care is provided by Local Care Direct Limited and is accessed via the practice telephone number or patients can contact NHS 111.

Updated 9 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at New Southgate Surgery 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 and 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.
• 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.

We saw areas of outstanding practice:

• The practice offered a specialist diabetes service which included insulin initiation and advanced care planning. In addition for those with more complex needs the practice hosted a diabetic clinicfour to six times a year with a specialist diabetes consultant. This reduced the need for those patients to attend secondary care.

• The practice had recently supported two open days organised and run by the Patient Participation Group (PPG) in conjunction with local voluntary groups to raise awareness amongst practice patients of issues such as diabetes, dementia and stroke and highlighted support that patients could access. These events had been popular with patients and feedback to both the practice and PPG was very positive.

The was one area where the provider should make an improvement:

• The practice needed to ensure that all staff members were aware of the location of emergency equipment such as the defibrillator, oxygen and emergency medicines within the building.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 9 August 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

• Patients with a history of prostate cancer received regular reviews as part of a shared care agreement with a local hospital.

• The practice had developed a number of self-management care plans for patients with long term conditions such as asthma, stoke and diabetes. The care plans were clear and could be easily understood by patients.

• The practice offered a specialist diabetes service which included insulin initiation and advanced care planning. In addition for those with more complex needs the practice hosted a diabetic clinic four to six times a year with a specialist diabetes consultant. Performance for diabetes related indicators was either comparable with or better than the national average. For example, 94% of patients on the diabetes register had a record of a foot examination and risk classification being carried out in the preceding 12 months compared to the national average of 88%.

• Longer appointments and home visits were available when needed.

• 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 9 August 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 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 practice’s uptake for the cervical screening programme was 82%, which was comparable to the CCG average of 83% and the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• The practice held weekly meetings with health visitors to discuss patient care and safeguarding issues.

• Staff carried out routine post-natal home visits approximately ten days post-delivery which included a full baby check and a post-natal check on the mother.

• A young person’s open access clinic had recently been established by the practice. Clinics were held weekly from 8am to 8.30am or 6pm to 6.30pm and allowed young people to discuss any health related issues that might be concerning them.

• The practice offered family planning clinics and was also part of the “C Card” scheme which offered young people up to the age of 25 access to free condoms  and sexual health advice.  

Updated 9 August 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. For example, the practice carried out activities which sought to avoid unplanned admission to hospital which included the identification of vulnerable patients, care planning and three monthly reviews.

• The practice was responsive to the needs of all patients including older people, and offered home visits and urgent appointments when these were requested. Home visits were assessed for prioritisation on a daily basis.

• Medication reviews were carried out regularly (usually on either a six or 12 month basis but more frequently if there was an identified need).

• High backed seating was available in the waiting room which was suitable for older people and those with mobility issues.

Updated 9 August 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. For example, the practice offered some early morning appointments starting at 7am and some late evening appointments up to 8pm on weekdays. In addition the practice also offered, in conjunction with other local practices, access to emergency appointments from 6.30pm to 8pm on weekdays and 9am to 3pm on Saturdays provided from a nearby practice.

• The practice offered telephone appointments for people wanting health advice but who may not be able to attend due to work commitments.

• 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. This included physiotherapy services and NHS health checks.

Updated 9 August 2016

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

• The practice carried out annual reviews of all patients on the mental health register and these were carried out more frequently if required.

• 88% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was better than the Clinical Commissioning Group average and national average of 84%.

• Performance for other mental health related indicators was either comparable with or better than the national average. For example, 94% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive agreed care plan documented in the record in the preceding 12 months compared to 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 about how to access various support groups and voluntary organisations.

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

Updated 9 August 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 and the frail elderly with complex needs.

• The practice offered longer appointments for patients with a learning disability or those who had difficulties in communicating.

• 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.

• The practice had worked with external voluntary groups who carried out an inspection of the practice to identify improvements that could be made for those with a sensory impairment. As a result of this a hearing loop was installed, signage was improved in the waiting room and staff received sensory impairment training. The practice also changed the new patient registration form to include information which would identify the most appropriate and preferred way to communicate with the patient.