Beechwood Medical Centre

Updated 7 June 2016

Beechwood Medical Centre is situated in Ovenden, Halifax. Ovenden is a small village approximately one mile from Halifax town centre. The practice has a patient list size of 8315 patients. Most of their patients (84%) are of white British origin. The practice is housed in single storey purpose built accommodation. The practice provides Personal Medical Services (PMS) under a locally agreed contract with NHS England. They offer a range of enhanced services such as extended hours access and childhood vaccination and immunisation..

There are four GP partners, two of whom are male and two female, and one male salaried GP. The clinical team also consists of one female nurse practitioner, three female practice nurses, a locum prescribing pharmacist and one female health care assistant. The clinical team is supported by a practice business manager, office manager, reception manager and a range of reception and administrative staff. The practice is a training practice and offers general practice experience to medical students and foundation year doctors wishing to gain experience in general practice.

The practice had recently undergone significant staff changes. Three nurse practitioners had left the practice within the last year and a new nurse practitioner had been recently recruited. A GP who had previously worked at the practice as a locum had also been appointed as a salaried GP. One of the GPs was due to retire at the end of the year, and the practice were seeking to recruit a replacement for him as well as an additional GP to augment the clinical team.

The practice catchment area is classed as being within one of the more deprived areas in England. People living in more deprived areas may have greater need to access health services. The age profile of the practice shows a slightly higher percentage of patients in the 0-34 year age group.

Beechwood Medical Centre is open between 8am and 6.30pm Monday to Friday. Extended hours are offered on Saturday between 9.30am and 12.30pm and on Sunday between 11am and 2pm.

Several clinics are held each week including asthma, epilepsy, diabetes and phlebotomy.

Out of hours cover is provided by Local Care Direct and is accessed via the surgery telephone number or by calling the NHS 111 service.

Beechwood Medical Centre is situated at 60a Keighley Road, Halifax, Calderdale HX2 8AL.

Beechwood Medical Centre has previously been inspected by the Care Quality Commission but did not receive a rating

Updated 7 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Beechwood Medical Centre on 15 March 2016. The practice has received an overall rating of good. Specifically we rated the practice as outstanding for providing responsive services people with long term conditions, families children and young people, working age people, people whose circumstances may make them vulnerable and people experiencing poor mental health.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• 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 available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care. Patients were able to access appointments seven days a week, 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.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw the following area of outstanding practice:

• The practice provided seven day access to appointments with GPs and nurses. This service was self-funded by the practice. The practice responded quickly to capacity and demand pressures. Availability of appointments and patient waiting times were reviewed constanty throughout the day. Additional appointments were made available on a daily or weekly basis as patient demand increased

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 June 2016

The practice was 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.

• 97% of patients with diabetes, on the register, had an influenza vaccination in the preceding year compared to the national average of 94%.

• The practice provided level four diabetic service to patients, enabling insulin and other injectable treatments to be initiated and monitored within the practice setting. The practice provided us with data which showed that only 3% of the patients on the diabetic register had been referred into hospital diabetic services in 2014 and 1% in 2015.

• Before patients attended for diabetic reviews they received a detailed summary and explanation of their most recent test results. Patients were invited to decide their own health priorities which were discussed with the clinician during their appointment.

• The practice clinical system had an icon which identified those patients with diabetes who were at greater risk of developing foot problems.

• Patients with other long term conditions were offered priority access to appointments without the need for telephone triage.

• Longer appointments and home visits were available when needed.

• 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.

Updated 7 June 2016

The practice was 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. Immunisation rates were relatively high for all standard childhood immunisations.

• 75% of patients with asthma, on the register had received an asthma review in the preceding 12 months which was the same as the national average.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals.

• Babies and pre-school children were given priority access to appointments.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• The practice ran a weekly well baby clinic in conjunction with the health visitors. Formal meetings were held bi-monthly with health visitors to discuss families and plan care for those who were identified as being in greater need.

Updated 7 June 2016

The practice was 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 complex needs.

• Before the inspection we sought feedback from a nursing home who had residents registered with the practice. They told us they were happy with the service provided by the practice.

• The practice provided data which showed that 30% of eligible patients had received their over 75 check in the previous year.

• The GPs routinely reviewed their care home patients on a six monthly basis.

Updated 7 June 2016

The practice was 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 accurately reflecting the needs of this age group.

• 78% of eligible women had a recorded cervical screening test within the preceding five years which was lower than the national average of 82%.

• The practice provided us with data which showed that 58% of eligible people had received the NHS health check in the preceding year, compared to the CCG average of 51%.

Updated 7 June 2016

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

• 80% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the national average of 84%.
• 91% of patients with schizophrenia or other psychoses had completed a comprehensive care plan within the preceding 12 months which was comparable to the national average of 88%.
• The practice worked with their local mental health services in the case management of people experiencing poor mental health, including those with dementia.
• The practice carried out advance care planning for patients with dementia.
• The practice gave patients experiencing poor mental health information about how to access local support groups and voluntary organisations such as the Social Prescribing (loneliness) project.
• 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.
• The practice offered a service to those patients needing to reduce their dependence on benzodiazepines. Benzodiazepines are drugs which produce a tranquilising effect and are used to treat symptoms of anxiety as well as sleeping problems and some other condtions.

Updated 7 June 2016

The practice was 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.

• The practice offered longer appointments for patients with complex needs.

• The practice liaised with multidisciplinary teams to assess need, plan care and monitor progress in the case management of vulnerable people.

• The practice gave vulnerable patients information about various support groups and voluntary organisations.

• The practice was part of a pilot utilising ‘ Social Prescribing’ which is intended to reduce social isolation and encourage integration.

• Staff gave us good examples of when they had recognised signs of abuse in vulnerable adults and children, and when safeguarding policies and procedures had been effectively applied. Contact details for relevant agencies both in and outside normal working hours were available on the electronic file which all staff were able to access.

• The practice had identified 1% of their patient list as carers. Carers were offered an annual health check and flu vaccination, and were given details of additional support services, such as Calderdale Carers’ Association