Archived: Greenside Surgery

Updated 4 February 2016

Greenside Surgery is a small practice providing services for 2405 patients under a General Medical Services (GMS) contract. It is a two story property located on Greenside in Cleckheaton town centre close to the bus station.

Greenside Surgery has recently undergone modernisation with upgraded consultation and treatment rooms. There are two GPs, one male and one female, a part time practice nurse, a practice manager and four administrative/reception staff members, one of whom also acted in the capacity of a phlebotomist. At the time of our visit the practice was operating without the services of the practice nurse.

Cleckheaton is a Metropolitan District Ward in Kirklees, it is in the fourth decile on the scale of deprivation for neighbourhoods in England. Levels of unemployment and patients with health-related problems in daily life are higher than the national average which can indicate an increased demand for GP services. Life expectancy is 78 for males and 82 for females.

The practice is open between 8.30am to 6pm Monday to Friday.

Appointments are from:

8.30 to 12pm and 4pm to 5.30pm Mondays;

8.30am to 11am and 1.50pm to 3.20pm Tuesdays;

8.30am to 11am and 5.15pm to 5.45pm Wednesdays;

8.30am to 11am and 4.30pm to 5.30pm Thursdays;

10am to 12pm and 3pm to 5pm Fridays.

From 8am to 8:30am and 6pm to 6:30pm telephone calls go through to Local Care Direct triage, for any urgent issues the receptionists are able to contact the GPs by mobile phone.

Extended hours surgeries are offered from 6:30pm to 7:45pm on Mondays. Appointments are reviewed at the beginning of each week and appointments are made available to suit patients wherever possible.

When the practice is closed out of hours services are provided by Local Care Direct and NHS 111.

Updated 4 February 2016

We carried out an announced comprehensive inspection at Greenside Surgery on 28 October 2015. 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.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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.
• 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.

We saw two areas of outstanding practice:

• The team at Greenside Surgery through patient consultations, written advice and other publicity had sought to reduce the demand for inappropriate prescribing of medicines . They had successfully reduced the prescription rate of some medicines and by involving the whole team ensured patients were given correct and consistent advice.
• The practice had achieved high rates of flu vaccination uptake for patients aged over 65 and patients in defined influenza clinical risk groups through proactively contacting and encouraging patients to attend.

However there were areas that the practice needs to make improvements:

Importantly the provider should:

• Ensure the floor in the waiting room is not a slip or fall risk to patients
• Ensure benzylpenicillin is available in case of suspected meningitis
• Ensure that emergency medicines and equipment are stored together to enable a fast response in the case of an emergency.
• Ensure that all GPs have up to date safeguarding training to level three

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 4 February 2016

The practice is rated as good for the care of people with long-term conditions. Both GPs had undertaken learning modules on injectable treatments for diabetics. One GP had completed a diploma in Chronic Obstructive Pulmonary Disease (COPD) which is a disease of the lungs and plans were in place to screen for COPD in patients who smoked. Patients at risk of hospital admission were identified as a priority. 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 medication 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. The practice actively encouraged at risk patients to attend for flu vaccination and uptake was considerably higher than the national average. 

Updated 4 February 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 accident and emergency (A&E) attendances. Uptake rates were relatively high for all standard childhood immunisations. Patients and staff told us 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 practice had an ethos of always seeing children up to the age of 16 years on the same day as requested. Parents/guardians were always contacted if a young child did not attend for their appointment. The premises were suitable for children and babies. Eight week checks and immunisations for babies were carried out by the GPs and used as an opportunity to review vulnerable families with new babies. A full range of family planning services was offered which included the fitting of implants and coils and providing emergency contraception.

Updated 4 February 2016

The practice is rated as outstanding for the care of older people. Nationally reported data 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 and end of life care. It was responsive to the needs of older people. The GPs had proactively identified housebound patients and offered annual home visits for this group, home visits and rapid access appointments were also available for those with enhanced needs. The practice had increased the uptake of flu vaccinations for this group to 79% and were working closely with the local medicines management team to review patients over the age of 75 who were taking ten or more repeat medications. 

Updated 4 February 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. Staff had the flexibility to offer patients who worked earlier or later appointments as required. The practice offered extended hours surgeries for working people.

Updated 4 February 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). There were 22 patients on the mental health register all of whom had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia. Reception staff had undertaken Dementia Friends training to enable them to support and better understand the needs of patients who had dementia, particularly when booking appointments or speaking to them on the telephone. The practice had told patients experiencing poor mental health 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 (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia. The practice hosted a counselling service run by the charity MIND which was open to members of the public and registered patients.

Updated 4 February 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 had a register of people with a learning disability for whom longer appointments were available. 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.