Archived: Prospect Surgery

Updated 12 September 2016

The practice operates from a main surgery which is located at Ossett Health Village, Kingsway in Ossett, West Yorkshire WF5 8DF. The practice serves a patient population of around 8,100 patients and is a member of NHS Wakefield Clinical Commissioning Group.

The surgery is situated in purpose built premises which opened in 2009. The surgery is located over two floors and is accessible for those with a physical disability as floor surfaces are level, doorways are wide and fitted with automatic doors and a passenger lift is available for use. The practice shares the building with another GP practice, the offices of the local GP Federation and extended hours service, community services and an independent pharmacy. There is parking available on the site for patients.

The practice population age profile shows that it is comparable with both the CCG and England averages for those over 65 years old (18% compared to the CCG average of 18% and England average of 17%). Average life expectancy for the practice population is 79 years for males and 83 years for females (CCG average is 77 years and 81 years and the England average is 79 years and 83 years respectively). The practice population is predominantly White British. The practice population lives in an area which is relatively affluent being in the fourth least deprived decile.

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

• Dementia support

• Risk profiling and case management

• Support to reduce unplanned admissions

• Improving patient online access

• Minor surgery

• Patient participation

• Extended hours

As well as these enhanced services the practice also offers additional services such as those supporting long term conditions management including asthma, diabetes, heart disease and hypertension, and physiotherapy.

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 five GP partners (two male, three female), one advanced nurse practitioner (male), three practice nurses, one health care assistant and one phlebotomist (all female). Clinical staff are supported by a practice manager and an administration and reception team. In addition the practice also has the services of a pharmacist and physiotherapists on site, as well as GP Registrars and Year One and Two medical students who are receiving training and gaining experience.

The practice appointments include:

• On the day/urgent appointments

• Pre-bookable appointments – up to four weeks in advance

• Telephone triage and consultations - where patients could speak to a duty GP to ask advice and if identified as being required obtain an appointment

• Home visits

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

The practice is open between 8am and 6.30pm Monday to Friday and offers extended hours opening on a Tuesday from 7am to 8am and on a Wednesday 6.30pm to 8.30pm. Additionally the practice works with other local GPs to offer appointments from 6.30pm to 8pm Monday to Friday and from 9am to 3pm on a Saturday and Sunday. This service is delivered from within the same building as Prospect Surgery.

The practice is accredited as a training practice and supports and hosts GP trainees 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 12 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Prospect Surgery on 2 August 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 with a GP 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.

The areas where the provider should make improvement were:

• The practice should review their stock checking procedures to ensure that all medicines available for use are in date.

• Review their arrangements for the checking of their fire alarms on a regular basis.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 12 September 2016

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

• GPs and nursing staff had lead roles in chronic disease management such as diabetes, and asthma. The practice kept registers of patients with long term conditions and used these to effectively manage treatment packages which included structured examinations, the development of personalised care plans and regular reviews.
• Longer appointments and home visits were available when needed.
• The practice hosted a monthly arthritis drop in clinic.
• The practice offered online-consultations with secondary care specialist consultants (an online-consultation is a mechanism that enables primary care providers such as GPs to obtain specialists' inputs into a patient's care treatment without requiring the patient to go to a face-to-face visit by using IT based communication links and data sharing).

• The practice delivered a diabetic clinic delivered in conjunction with a local secondary care provider. The practice also offered specialist care management and enhanced services such as insulin initiation in-house.

• 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.

Updated 12 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.
• Immunisation rates were relatively high for all standard childhood immunisations.
• We were told by staff that that children and young people were treated in an age-appropriate way and were recognised as individuals.
• The practice was working towards Young People Friendly Accreditation. Once achieved, this would demonstrate that the practice had effectively engaged with young people and sought to meet their specific needs.
• The practice was a c-card distribution centre which gave improved access to contraceptives for young people, and chlamydia screening was available (chlamydia is a common sexually transmitted disease which may not show obvious symptoms).
• The practice’s uptake for the cervical screening programme was 85%, which was above the CCG average of 84% and the national average of 82%. In addition the practice followed up cervical screening non-attenders.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice contacted new mothers to explain the registration process and to arrange postnatal and six week baby checks.

Updated 12 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 and wherever possible prioritised continuity of care.
• The practice was responsive to the needs of older people, and the duty doctor was available all day for triage and late home visit requests.

• The practice delivered an avoiding unplanned admissions service which provided proactive care management for patients who had complex needs and were at risk of an unplanned hospital admission. At the time of inspection the practice had 122 patients on their avoiding unplanned admissions register.

• The full practice team was involved in annual flu, pneumococcal and shingles programmes which included dedicated weekend clinics.
• The practice offered electronic prescribing, sending prescriptions direct to the patient’s pharmacy of choice. This made the prescribing and dispensing process more efficient and convenient for patients.

Updated 12 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. For example, the practice offered extended hours opening and participated in the Measles, Mumps and Rubella and Meningitis C catch up programme for young people.
• Extended hours opening was available to meet the needs of patients who could not come to the surgery during regular operating hours.
• The practice was proactive in offering online services which included appointment booking, prescription ordering and medical records access.
• The practice offered a full range of health promotion and screening that reflects the needs for this age group, this included referrals to other organisations such as health trainers and hosting cognitive behavioural therapy sessions.

Updated 12 September 2016

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

• Performance for mental health related indicators was generally better than the CCG and national averages. For example, 96% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the preceding 12 months compared to the CCG average of 89% and 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 12 September 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held registers 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 as well as offering an annual health check.
• The practice IT system identified patients who had specific communication needs.
• 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.
• Staff proactively followed up vulnerable patients who did not attend appointments or referrals.