Pitsmoor Surgery

Updated 18 July 2016

Pitsmoor surgery is situated in Sheffield city centre. The practice provides services for 9,363 patients under the terms of the NHS Personal Medical Services contract. The practice catchment area is classed as within the group of the first most deprived areas in England. The practice population has a high rate of patients under 18 years (30%) which is significantly above the CCG and England average. Two thirds of the population are from a range of ethnic groups.

The practice has seven GP partners (six female and one male), one salaried business partner (male), two salaried GPs (one male, one female), four GP registrars (all female), two nurse practitioners (both female), one practice nurse (female) and four healthcare assistants (all female).   They are supported by a team of practice management staff and an administration team.

The practice is open between 8.30am and 6pm on Monday, Tuesday, Thursday and Friday and 8.30am to 8.00pm on Wednesdays (closed between 12.30pm and 2.00pm for staff meetings and training).  The practice offers daily telephone triage with access to same day appointments.  There are also pre-bookable appointments through the week.  Extended hours are offered on Wednesday evenings until 8pm, Friday mornings from 7.30am to 8.30am and each Saturday morning.  When the practice is closed calls were answered by the out-of-hours service which is accessed via the surgery telephone number or by calling the NHS 111 service.  

Updated 18 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Pitsmoor Surgery on 18 May 2016. 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 report incidents and near misses. Opportunities for learning from internal and external incidents were in place.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, the practice is an Advanced Training Hub working in collaboration with Sheffield Hallam University in the training and development of student nurses. The practice is also part of a neighbourhood working pilot in conjunction with the local Intermediate Care team to improve and develop access to services for patients living in the local community.
• Feedback from patients about their care was consistently positive.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group. For example, the design of the front reception area was changed to ensure patient confidentiality; disabled parking spaces were allocated and clearly marked at the front of the surgery to ensure ease of access and patients were involved in the interview and selection of new practice staff.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice actively reviewed complaints and how they are managed and responded to, and made improvements as a result.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.

We saw three areas of outstanding practice including;

• The practice rate of severe mental illness is three times above the city average and in response, the practice had been supporting a Primary Mental Health Care Project for over 20 years. This initiative provides enhanced care to patients with severe and enduring mental health needs who do not engage with other services. The project is run by staff with diverse professional backgrounds within the team who offer person centered care to improve the quality of life for people suffering with poor mental health. Individual and group work approaches are offered to these patients to reduce social isolation, increase self esteem and encourage them to participate in specific activities such as theatre trips, photography classes, singing clubs and chairobics.
• SAGE Greenfingers is a registered charity which developed in partnership with Pitsmoor surgery.  It is a horticultural therapy project to improve mental health through gardening for patients with severe and enduring mental health needs. The project offers patients the time and space to unwind, the opportunity to make new friends with organised transport and interpreters if needed.  The practice has allocated five dedicated allotments for use by this group of patients.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. For example, the practice provided Roma Slovak services in direct response to the demographic needs of the local population (12% of the patient population are Slovakian).  This service offers patients; weekly booked surgeries with interpreters, dedicated new patient checks each Thursday, the promotion of community events including language classes, Hepatitis B screening including contact tracing and liaison with local schools and the Multi-Agency Support Team (MAST).  

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 July 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.
• Performance for diabetes related indicators was above the CCG and national averages. For example, the percentage of patients with diabetes, on the register, who had a blood test to measure their average blood sugar levels was 85% (CCG average, 78%; national average, 78%).
• 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 18 July 2016

The practice is rated as outstanding 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 satisfactory 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, and we saw evidence to confirm this.
• The the practice offers ed a well attended drop in contraception and sexual health clinics during the mid afternoon and evening to encourage young people to uptake these services at a time which was issuitable to them i.e. after school or college.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice has a high rate of patients under 18 years which is significantly above both the CCG and England average.  In response they offers ed a daily under 16 years drop in clinic and reserved under 16 years appointments each afternoon.
• We saw positive examples of joint working with midwives and health visitors to promote health and well being for families and their children.

Updated 18 July 2016

The practice is 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 enhanced needs.
• The practice was working in collaboration with the multidisciplinary team and the consultant geriatrician and developed advanced care plans for patients living in three local nursing homes and one residential home.

Updated 18 July 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 18 July 2016

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

• The practice rate of severe mental illness is three times above the city average and in response, the practice had been supporting a Primary Mental Health Care Project for over 20 years. This initiative provides enhanced care to patients with severe and enduring mental health needs who do not engage with other services. The project is run by staff with diverse professional backgrounds within the team who offer person centered care to improve the quality of life for people suffering with poor mental health. Individual and group work approaches are offered to these patients to reduce social isolation, increase self esteem and encourage them to participate in specific activities such as theatre trips, photography classes, singing clubs and chairobics.
• SAGE Greenfingers is a registered charity which developed in partnership with Pitsmoor surgery. It is a horticultural therapy project to improve mental health through gardeningfor patients with severe and enduring mental health needs. The project offers patients the time and space to unwind, the opportunity to make new friends with organised transport and interpreters if needed. The practice has allocated five dedicated allotments for use by this group of patients.
• 81% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average of 84%.
• Performance for mental health related indicators was similar to the CCG and national averages. For example, the percentage of patients which schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan documented in the record in the preceding 12 months was 89% (CCG average, 90%; national average, 88%).
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with living with dementia.
• The practice carried out advance care planning for patients living with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• 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 those living with dementia.

Updated 18 July 2016

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