Whitby Group Practice

Updated 28 June 2017

Whitby Group Practice, Spring Vale, Whitby, North Yorkshire, YO21 1SD. There is a large car park available at the practice. The practice is in a purpose built building with disabled access and consulting and treatments rooms available on the ground floor. There is one branch practice, Robins Hoods Bay, Station Road, Robin Hoods Bay, North Yorkshire, YO22 4RA.

The practice has a Primary Medical Services contract with NHS England, North Yorkshire, Hambleton, Richmondshire and Whitby Clinical Commissioning Group (CCG). The total practice patient population is 14,273 covering patients of all ages. The practice and branch practice are a ‘dispensing practice’ and is able to dispense medication to patients who live more than one mile from the nearest pharmacy.

The proportion of the practice population in the 65 years and over age group is representative of the England average. The practice scored five on the deprivation measurement scale, the deprivation scale goes from one to ten, with one being the most deprived. People living in more deprived areas tend to have a greater need for health services.

The staff team comprises 15 GPs (eight female and seven male). This equated to 8.25 GP partners and a full time GP. There are nine registered nurses of varying grades, one outreach nurse, two research nurses and seven health care assistants. The practice is managed and supported by one practice manager, one deputy practice manager, one finance manager, three heads of department, four receptionists, three records clerks, two secretarial support, seven dispensers and six cleaners.

The practice is a training practice for medical students from the Hull York Medical School. It takes up to four GP specialist trainees and year four and five medical students, second year foundation doctors and nursing students. The practice is also a research practice and has a GP who leads in research along with two research nurses. The practice also provides GP and minor injuries cover to the local community hospital and provide support to the local hospice.

The practice reception is open Monday to Friday 8am until 6.30pm (excluding bank holidays), with appointments being available between 8.30am and 11.30am, 3.00pm and 5.30pm with extended hours on a Thursday between 6.30pm and 8.00pm. The branch practice at Robin Hoods Bay was open between 8.30am and 12.30pm and 2pm and 5.30pm Monday to Friday with the exception of Wednesday when it was open 8.30pm – 12.30pm. Appointments were available at the same time as the opening hours. The practice operates a telephone triage system for urgent appointments, through the use of a duty doctor. Face to face appointments are available daily for patients at the walk in clinic held each morning. The practice telephones switch to the out-of-hours provider at 6.30pm each evening and at weekends and bank holidays. The practice is a teaching practice and teaches third and fifth year medical students.

Updated 28 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Whitby Group Practice on 6 October 2016. The overall rating for the practice was good, with the key question of safe rated as requires improvement as the arrangements in respect of medicines management did not assure that risks had been minimised. The full comprehensive report published on 15 December 2016 can be found by selecting the ‘all reports’ link for Whitby Group Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 13 June 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach of regulation we identified in our previous inspection on 6 October 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Our key findings were as follows:

• Care and treatment was provided in a safe way for service users through the proper and safe management of medicines for the purposes of the regulated activity.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 15 December 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.

• The practice nurse could initiate insulin (start the use of insulin and monitor to ensure correct dosage).This provided patients with treatment closer to home.

• The practice provided an in-house anticoagulant service (monitoring and management of medication that prevent blood clots). They also provided three leg ulcer clinics. This again provided patients with treatment closer to home.

• 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.

• Longer appointments and home visits were available when patients needed them.

• Staff regularly undertook training to keep them up to date with current best practice for the management of long-term conditions.

Updated 15 December 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.

• Monthly child safeguarding meetings took place with all relevant professionals.

• Childhood immunisation rates for the vaccinations given were slightly higher when compared to the CCG average for under two year olds and for five year olds. For example childhood immunisation rates for the vaccinations given to under two year olds ranged from 97% to 99% compared to the CCG average of 91% to 96% and England average of 73% to 95%. For five year olds from 93% to 96% compared to the CCG average of 91% to 96% and England average of 81% to 95%.

• The practice’s uptake for the cervical screening programme was 80%, which was slightly below the CCG average of 84% and the national average of 82%.

• The practice provided a full range of contraceptive services.

• 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, health visitors and school nurses.

Updated 15 December 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.

• The practice employed an outreach nurse to support patients who lived in nursing or residential care homes.Support included assessment of acute and chronic problems, liaising with their named GP and continuing care planning. They also provided education/training programmes which included care home staff, district nursing staff and practice staff.

• A prescription delivery service was provided to housebound or vulnerable patients who were unable to collect their prescriptions.

Updated 15 December 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 telephone consultations and online services as well as a full range of health promotion and screening that reflected the needs for this age group.

• Family planning clinics, minor surgery and joint injections were provided at the practice so patients did not have to attend hospital to access these services.

• Extended hours were available each Thursday for both GP and Nurse appointments.

• Information and testing kits for sexually transmitted diseases were available in the practice.

• The practice had facilities(centrifuge) so bloods could be taken at all times through the day.

• 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.

Updated 15 December 2016

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

• 75%of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is below the national average of 84%.

• Performance for mental health related indicators were above the CCG and National Averages. For example the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had had a comprehensive, agreed care plan documented in their record, in the preceding 12 months (01/04/2014 to 31/03/2015) was 97% compared to the national average of 90%.

• 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.

• 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 15 December 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 and those with a learning disability. Homeless people were registered at the practice address.

• 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.

• Drug and alcohol services were provided on-site in conjunction with local support group in a shared care capacity.

• 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.

• Palliative care patients had an alert on their records and the practice had a policy that these patients would be seen by their named GP.

• The practice had a member of staff who was a carer’s champion. The practice had identified that 5% of their practice population were carers. They provided them with health care and support.

• The practice employed an out-reach nurse who provided care and treatment to patients living in care homes and housebound patients.