Escrick Surgery

Updated 4 February 2016

Escrick Surgery is located in the village of Escrick situated outside York. Escrick Surgery is a member of the NHS Vale of York Clinical Commissioning Group. The practice has a registered population of 6045 patients. It is located in an area of low deprivation in the least deprived 10% in the country. The practice is accommodated in a purpose built surgery with good disabled access, and also has a branch surgery two miles away at North Duffield. The main surgery is located in Escrick village, while the branch surgery operates from of North Duffield. The practice holds a General Medical Services contract with NHS England and also dispenses medication from the Escrick site.

There are five GP’s (two male and three female) at the practice, of which two are GP partners and three salaried. In addition to the GP’s the practice has a nurse manager. a practice nurse, and two health care assistants. The management team consists of a practice manager, reception manager and a dispensary manager. There were nine reception and dispensary staff supporting the administration of the practice.

The practice is open between 8.00am and 6.00pm Monday to Friday; however the branch surgery is open for three mornings per week. Appointments are delivered over morning and afternoon sessions.

The practice also attended a local boarding school where 260 of their registered patients resided. They also attended a large local nursing home on a weekly basis to meet the needs of their patients.

Out of hours services are provided by Primecare which is accessed through the normal practice telephone number or through NHS 111.

The practice is registered to provide regulated activity at both the main site and branch surgery for: Diagnostic and screening procedures; family planning; treatment of disease, disorder or injury; maternity and midwifery services; and surgical procedures.

We inspected both main and branch surgeries.

Updated 4 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Escrick Surgery on 16 September 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 easy to understand and was available in the practice leaflet and on request.
• Urgent appointments were available on the same day.
• The practice had good facilities and was well equipped to treat patients and met 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 one area of outstanding practice:

• Seven day care to patients in the last few weeks of life by the same GP by daily telephone calls ensuring consistent and reassuring care.

However there were areas of practice where the provider needs to make improvements.

Practice clinical meetings should involve all clinical staff, including nurses, to ensure consistency and learning is shared and  that decisions and actions from significant events are communicated effectively to all.

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. 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 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.

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 A&E attendances. Immunisation rates were relatively high 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. Appointments were available outside of school hours, and in the local boarding school (for the pupils), and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 4 February 2016

The practice is rated as good 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, and offered home visits and rapid access appointments for those with enhanced needs.

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 reflects the needs for this age group.

Updated 4 February 2016

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

The practice had told patients experiencing poor mental health about 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.

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 offered longer appointments for people with a learning disability.

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.