Alwoodley Medical Centre

Updated 7 April 2017

Alwoodley Medical Centre is located in a new, purpose built building on Saxon Mount, Leeds, West Yorkshire, LS17 5DT. The practice reception and clinical rooms are located on the ground floor, with offices and meeting rooms being located on the first floor. There is also a branch site, Adel Surgery, located at 141 Long Causeway, Adel, Leeds, West Yorkshire, LS16 8EX. Both sites are accessible for wheelchairs and parking for both staff and patients.

The practice is situated within the Leeds North Clinical Commissioning Group (CCG) and provides primary medical services under the terms of a General Medical Services (GMS) contract. This is a contract between general practices and NHS England for delivering services to the local community.

Information published by Public Health England rates the level of deprivation within the practice population group on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. The practice is assessed as being situated in level seven; one of the lesser deprived areas.

Alwoodley Medical Centre registered as a partnership with the Care Quality Commission in July 2016. This was following a merger of two local practices and relocation into the new building. The partnership is made up of 11 GP partners (six male and five female). Working alongside the partners is one female salaried GP, one senior nurse, four practices nurses, three health care assistants and one medicines waste support worker. The clinical team are supported by an experienced team of administrative and secretarial staff.

At the time of our inspection the practice trained second year foundation students (FY2) and medical students. The practice were also in the process of becoming a training practice to support GP Registrars from August 2017.

The practice serves a population of approximately 15,000 patients who can access a number of clinics, for example minor surgery; contraception services and childhood immunisations.

The practice is open between the hours of 8am and 6pm Monday to Friday. In addition, the practice provides extended hours from 7am until 8am on Monday mornings and 6pm until 8pm on Monday evenings.

Appointments are available between the following hours:

Monday: 7am until 7.45pm

Tuesday – Friday: 8am until 6pm

When the practice is closed out-of-hours services are provided by Local Care Direct, which can be accessed via the surgery telephone number or by calling the NHS 111 service.

Updated 7 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Alwoodley Medical Centre on 21 February 2017. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.

• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• 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.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider should make improvements are:

• Develop a system to follow up the completion of actions resulting from incidents and significant events.
• Develop a system to accurately record all information relating to complaints.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 April 2017

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.
• The health care assistant at the practice had attended training to enable them to provide diabetic foot checks. This enabled the nursing staff within the practice to concentrate on discussions with patients around self-management of care.
• Patients with more than one long term condition were invited to attend one annual appointment to avoid them having to make repeated visits to the practice.
• Due to Alwoodley Medical Centre being a new provider, there was no published Quality and Outcomes Framework (QOF) data available. However; the practice were able to provide us with their current overall performance figures against the diabetes indicators and at the time of our inspection had achieved 84% of the total number of QOF points available.
• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.
• The practice used a computerised system to monitor disease-modifying anti-rheumatic drugs (DMARDS) and high risk medication to ensure patients received appropriate follow up.
• All these patients had a named GP and there was a system to recall patients for 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 7 April 2017

The practice is rated as good for the care of families, children and young people.

• There were systems 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.
• Immunisation rates were relatively high for all standard childhood immunisations.
• Patients told us, on the day of inspection, 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 the premises were suitable for children and babies.
• The practice offered booked appointments for baby checks and childhood immunisations.
• The practice worked with midwives, health visitors and school nurses to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics. In addition; the practice hosted three midwife sessions per week.
• The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications.
• The practice offered a full range of contraception services including coils and implant clinics.

Updated 7 April 2017

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

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.
• The practice offered proactive, personalised care to meet the needs of the older patients in its population.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.
• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.
• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible. For example, the practice directed patients to the Connect Well social prescribing service. This gave patients the opportunity to access support in the local community.
• The practice had a dedicated lead GP who carried out weekly care home visits.
• The practice had a dedicated health care assistant who provided home visits to older and vulnerable patients. This role included providing support and referral to other services such as podiatry; incontinence service, adult social services and the district nursing team.
• The practice was involved in the avoiding unplanned admissions scheme which identified the 2% of the patient list who were most at risk of unplanned hospital admission and ensured care plans and interventions were in place to reduce this risk.
• The practice had achieved 81% uptake in the annual flu campaign for patients aged 65 and over.

Updated 7 April 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these populations had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care, for example, extended opening hours on Monday morning from 7am until 8am; and Monday evening from 6pm until 8pm.
• 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 7 April 2017

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

• The practice carried out advance care planning for patients living with dementia.
• Due to Alwoodley Medical Centre being a new provider, there was no published data available. However; the practice were able to provide us with current overall performance figures and at the time of our inspection had achieved 99% of the total number of Quality and Outcomes Framework point available against the dementia related indicators and 93% of the total number of points against the mental health related indicators.
• The practice specifically considered the physical health needs of patients with poor mental health and dementia. For example; patients who did not attend for antipsychotic medication were contacted, the practice referred to other services such as mental health teams and drug and alcohol misuse programmes.
• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• Patients at risk of dementia were identified and offered an assessment.
• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.
• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia.

Updated 7 April 2017

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.
• The practice ran regular searches to identify patients with a learning disability and invited them to attend a physical review either at the practice or during a home visit.
• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.
• 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 had a dedicated health care assistant who provided home visits to vulnerable patients. This role included providing support and referral to other services such as podiatry; adult social services and the district nursing team.
• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.
• GPs within the practice were involved in health inequalities work identifying hard to reach patients and improving their engagement and care.
• Staff interviewed 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.