Dr Ellis Rickwood and Partners Also known as Crossley Street Surgery

Updated 12 November 2015

Dr Richard Hall and Partners operate from Crossley Street Surgery in the semi-rural town of Wetherby. The practice serves a population of approximately 11,000 patients.

The practice operates from a two-storey, purpose built property with lift access for patients wishing to access the second floor for treatment.

At the time of our inspection the service was provided by four GP partners (three male and one female) and six salaried GPs (five female and one male). Working alongside the GPs are four practice nurses, an advanced nurse practitioner and two healthcare assistants. The clinical team are supported by a practice manager and a team of administrative and reception staff.

The practice has a Personal Medical Services (PMS) contract. This is the contract between general practices and NHS England for delivering services to the local community. They also offer a range of enhanced services, such as minor surgery and remote care monitoring.

Crossley Street Surgery opens from 8am to 6.00pm Monday to Friday. Appointments are from 8.30am to 11am and 2pm and 6pm daily.

Patients needing to see a GP outside of normal working hours are advised to contact the GP out of hours service provided by Local Care Direct. This is accessed via the surgery telephone number or by calling the NHS 111 service.

Updated 12 November 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Richard Hall and Partners at Crossley Street Surgery on 28 July 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.
• 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 one area of outstanding practice:

• All staff had been trained through “Dementia Friends” and this enabled them to better understand and provide for the needs of dementia patients and their carers.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 12 November 2015

The practice is rated as good for the care of people with long-term conditions. The practice had dedicated clinical leads in all relevant areas. In addition all practice nurses at the practice were trained in at least one long term condition and held dedicated clinics throughout the year. Longer appointments and home visits were available when needed. All patients had a named GP and a structured annual review to check that their health and medication needs were being met.

Updated 12 November 2015

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. Baby and immunisation clinics were run to ensure complete checks (including post natal) were undertaken at appropriate times and there was a process in place to follow up any child who did not attend for scheduled immunisations. We saw good examples of joint working with midwives, health visitors and school nurses and after school asthma clinics were available for school aged children.

Updated 12 November 2015

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. The practice served three nursing homes in the area and offered dedicated prescription services to ensure medications were ordered correctly.

The practice also worked as part of the Wetherby locality within the Leeds North Clinical Commissioning Group (CCG) to utilise a funding stream from the Better Care Fund (this is an incentive fund for the NHS and local government to work more closely together around people, placing their well-being as the focus of health and care services). This involved supporting frail, elderly and vulnerable patients in their own homes.

Updated 12 November 2015

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 and had been identified by NHS England as one of the top ten practices in the North of England for online repeat prescribing. There were a full range of health promotion and screening that reflected the needs for this population group, such as Saturday morning flu clinics to ensure this group of patients were captured.

Updated 12 November 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Ninety one percent of people experiencing poor mental health had a comprehensive, agreed care plan documented in their record.

The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia and had undertaken an audit of mental health anti-psychotics. This had resulted in a new template and improved recall for annual GP hoslistic mental health checks. 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 12 November 2015

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 and offered longer appointments for these patients.

The Advanced Nurse Practitioner and a practice nurse were specifically trained in managing patients with a learning disability and offered home visits to carry out health checks and flu vaccinations for those patients who were unable attend the practice.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. They signposted vulnerable patients 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.