Oughtibridge Surgery

Updated 15 May 2017

Oughtibridge Surgery is located in a purpose built health centre and accepts patients from Oughtibridge and the surrounding area in Sheffield. Public Health England data shows the practice population has a higher than average number of patients aged 40 to 85 years compared to the England average. The practice catchment area has been identified as one of the 8th least deprived areas nationally.

The practice provides General Medical Services (GMS) under a contract with NHS England for 5873 patients in the NHS Sheffield Clinical Commissioning Group (CCG) area. It is a dispensing practice and dispensers medication to approximately 25% of the practice population living in outlying villages. It also offers a range of enhanced services such as anticoagulation monitoring, contraceptive services and childhood vaccination and immunisations.

Oughtibridge Surgery has five GP partners (three female, two male), two practice nurses, two healthcare assistants, three dispensers, practice manager and an experienced team of reception and administration staff.

The practice is open 8am to 6.30pm Monday to Friday with the exception of Thursdays when the practice closes at 12.30pm. The Sheffield GP Collaborative provides cover when the practice is closed on a Thursday afternoon. Extended hours are offered on alternate Tuesday evenings until 8pm and one Saturday morning 9am to 12 noon a month. Morning and afternoon appointments are offered daily Monday to Friday with the exception of Thursday afternoon when there are no afternoon appointments.

When the practice is closed between 6.30pm and 8am patients are directed to contact the NHS 111 service who will offer advice or refer to the GP Collaborative if appropriate. Patients are informed of this when they telephone the practice number.

As part of the Care Quality Commission (Registration) Regulations 2009: Regulation 15, we noted during the inspection on 1 June 2016 that the GP partners registered with the Care Quality Commission as the partnership did not reflect the GP partners at the practice. It was noted at the follow up inspection on 13 March 2017 that this had not been resolved. The practice manager confirmed applications were being progressed through CQC.

Updated 15 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Oughtibridge Surgery on 1 June 2016. The overall rating for the practice was good with requires improvement in well led. The full comprehensive report from 1 June 2016 can be found by selecting the ‘all reports’ link for Oughtibridge Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 13 March 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 1 June 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated good. Specifically, following the focused inspection we found the practice to be rated good for being well led.

Our key findings were as follows:

• The practice had implemented a system to monitor and track blank prescriptions within the practice.

• We saw evidence staff were following practice policies.

• We saw evidence risk assessments had been monitored and reviewed. For example, fire and legionella risk assessments had been updated.

• The practice had completed a risk assessment of staff who performed chaperone duties and staff who had direct patient contact who had not received a DBS check. A rolling programme to complete this by the end of March 2017 had been implemented. The practice provided evidence following the inspection that these had been completed or applied for. (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable).

• The practice had completed a risk assessment to ensure the appropriate emergency drugs were available to staff in a central location in an emergency.

• A risk assessment of the security of the dispensary and access to the controlled drug cupboard key had been completed.

• Training updates for the practice nurses and competency assessments of dispensary staff had been completed.

• The practice had an up to date record of clinical staffs’ immunity status as specified in the national Green Book (immunisations against infectious disease) guidance for healthcare staff.

• The practice had installed a thermometer in the dispensary to monitor the ambient room temperature to ensure drugs were stored at temperatures specified in national guidance.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 11 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 and 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 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 11 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 were comparable to national averages for all standard childhood immunisations.

• Staff told us that children and young people were treated in an age-appropriate way and were recognised as individuals.

• Data showed 82% of women eligible for a cervical screening test had received one in the previous five years which was comparable to the national average of 82%.

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

• We saw positive examples of joint working with midwives and health visitors.

Updated 11 August 2016

The practice is rated as good for the care of older people.

• The practice offered 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.

• The practice provided medical care and weekly routine GP visits to patients who resided in a local care home.

• The percentage of patients aged 65 or over who received a seasonal flu vaccination was 73%, which was comparable to the national average of 73%.

Updated 11 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.

• The practice offered evening appointments one evening a week on alternate Tuesdays and one Saturday morning a month at the practice and weekend and evening appointments at a local practice through the Sheffield satellite clinical scheme.

• 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.

Updated 11 August 2016

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

• Of those patients diagnosed with dementia, 87% had had their care reviewed in a face to face meeting in the last 12 months, which is higher than the national average of 84%.

• Of those patients diagnosed with a mental health condition, 60% had a comprehensive care plan reviewed in the last 12 months, which is lower than the national average of 88%. The GP told us all patients were called in annually for a physical check and the care plans completed by the community mental health team were not comprehensive enough for the GPs to code as completed.

• The practice regularly worked with multidisciplinary teams in the case management of patients experiencing poor mental health, including those living 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.

• 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.

• The practice hosted Improving Access to Psychological Therapies Programme (IAPT), a counselling service to support patients’ needs.

Updated 11 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.

• 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.

• The practice provided medical care to most patients who resided in a nearby sheltered housing complex.

• 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.