Archived: Wetherby Surgery

Updated 3 September 2015

Wetherby Health Centre is located in a Local Improvement Finance Trust (LIFT) purpose built health centre situated in Wetherby town. The main surgery has operated from this site since 2008. There is also a branch surgery based at Harewood, which has a small dispensary for the 800 patients it serves in that area. There is no dispensary at the main branch.

The practice provides services for a population of 3696 patients under the terms of a locally agreed NHS General Medical Services (GMS) contract. The majority of the registered patients are of white British origin. The practice has a higher than average number of patients aged over 50 years, in comparison to national figures.

Wetherby Health Centre is registered to provide the following regulated activities: treatment of disease, disorder or injury; family planning; diagnostic and screening procedures.

The practice has a male GP lead and three female salaried GPs. The lead GP is currently an elected non-executive director for Leeds North Clinical Commissioning Group (CCG) and also chairs the local GP group for the Wetherby area. The nursing team consists of two female practice nurses and a healthcare assistant. The non-clinical staff consists of a practice manager who leads a team of administration and reception staff. Two of the reception staff are trained to be dispensers at the Harewood branch surgery. Staff rotated between the two locations.

Wetherby Health Centre is open between 8am and 6pm Monday to Friday. The Harewood branch surgery is open Monday, Wednesday, Thursday, Friday between 8.30am and 12.30pm and 3.30pm to 6pm on Tuesday.

Patients can access the appointment system in person at reception, by telephone or online via the practice website. Some appointments are pre-bookable and others are bookable on the day. The practice also offers same day appointments for urgent cases. When the practice is closed, out of hours cover for emergencies is provided by NHS 111 and Leeds Primary Care Trust.

We were told how the practice had managed the delivery of services and patient care during the period after two of the three GP partners and a practice manager had resigned. Staff told us some of the difficulties they had encountered during this time, including the unsuccessful attempts to recruit further GPs. At the time of our inspection the practice was in the final stages of being taken over by OneMedicalGroup. As a result of this, the availability of regular GPs had increased.

Updated 3 September 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Wetherby Health Centre on 1 July 2015. Overall the practice is rated as good.

Specifically, we rated the practice as good in providing safe, effective, caring, responsive and well-led services and care for all of the population groups it serves.

Our key findings 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.
• Patients said they were treated with compassion, dignity and respect and were involved in care and decisions about their treatment.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Overall risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Information about services and how to complain was available and easy to understand. Complaints were addressed in a timely manner and the practice endeavoured to resolve complaints to a satisfactory conclusion.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients.

However, there was an area of practice where the provider needs to make improvements. Specifically, the provider should:

• Ensure the room door is locked where emergency medicines are kept, as this is in a patient accessible area.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 3 September 2015

The practice is rated good for the care of people with long term conditions. The GPs and nursing staff had lead roles in chronic disease management such as diabetes and respiratory conditions. Chronic disease management templates were used to support consistent delivery of care. Longer appointments and home visits were available when needed. There were structured annual reviews in place to check the health and medication needs of patients were being met. Wetherby Health Centre, in conjunction with four local practices, had co-funded the employment of three additional nurses to work with the practices in relation to the hospital admission avoidance scheme. Patients who were identified as being at high risk for a hospital admission were managed and supported to reduce their risk of an unnecessary admission.

Updated 3 September 2015

The practice is rated 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 & emergency department (A&E) attendances. The practice provided sexual health support and contraception, maternity services and childhood immunisations. Data showed immunisation uptake rates were at or above average for Leeds North Clinical Commissioning Group. Appointments were available outside of school hours and the premises were suitable for children and babies. Staff we spoke with told us children would always be seen on the same day as requested if needed.

Updated 3 September 2015

The practice is rated good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. All patients over 75 years of age had a named GP. The practice was responsive to the needs of older people, offering home visits and longer appointments. The practice worked closely with relevant health and social care professionals to deliver a multidisciplinary package of care. They also worked with voluntary services, such as Wetherby in Support of the Elderly (WISE) and the Home from Hospital Service operated by the Red Cross, to support older people to live independently in their own homes.

Updated 3 September 2015

The practice is rated good for the care of working age people (including those recently retired and students). Although the practice did not have extended hours they would offer appointments at the beginning or end of surgery to accommodate patients who found it difficult to attend during normal surgery hours. They also offered telephone consultations. For patients who could not access the surgery for their prescriptions during the week, these were sent to the local chemist for a Saturday collection if needed. There was a range of health promotion and screening programmes offered, which reflected the needs of this population group.

Updated 3 September 2015

The practice is rated good for the care of people experiencing poor mental health, including people with dementia. Annual health reviews, longer appointments and appropriate home visits were offered for all patients within this population group. Ninety five percent of patients who had a diagnosis of dementia had received a face to face review of their care needs. This was significantly higher than the 84% average for local practices.

The practice worked with other multidisciplinary teams in the case management of people in this population group. They informed patients how to access various support groups and voluntary organisations. For example, signposting patients and carers to the Alzheimer’s Society.

Updated 3 September 2015

The practice is rated 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 who had a learning disability. These patients were offered an annual health check and longer appointments were available where required. The practice advised vulnerable people how to access various support groups and voluntary organisations. It regularly worked with multidisciplinary teams in the case management of vulnerable people. For example, they hosted weekly sessions run by a local agency to support people who had a drug or alcohol addiction.

Staff knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.