Burncross Surgery

Updated 5 August 2016

Chapelgreen Practice, which incorporates Burncross Surgery and a branch surgery at High Green Health Centre, is situated in Sheffield. The practice provides services for 15,763 patients under the terms of the NHS Personal Medical Services contract. The practice catchment area is classed as within the group of the fourth more deprived areas in England. The age profile of the practice population is similar to other GP practices in the Sheffield Clinical Commissioning Group (CCG) area however there are significant numbers of older people (higher than 20%).

The practice has eight GP partners (three female and five male), four salaried GPs (all female), two nurse practitioners, five practice nurses and four healthcare assistants. They are supported by a team of practice management staff and an administration team.

The practice is open between 8am and 6pm Monday to Friday. Extended hours are offered on Tuesdays, Wednesdays and Fridays from 7 am, Tuesdays until 8pm and one Saturday per month by appointment. Appointments with staff are available at various times throughout the day. Patients requesting same day appointments are triaged over the telephone by the practice nurse and offered a face to face appointment if required.

When the practice is closed calls were answered by theout-of-hours service which is accessed via the surgery telephone number or by calling the NHS 111 service.

Updated 5 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Chapelgreen Practice on 30 June 2016. 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 an effective system in place for reporting and recording significant events.
• Risks to patients were generally assessed and well managed.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Most patients said they found it easy to make an appointment with a named GP and 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.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw two areas of outstanding practice:

• The practice was committed to becoming a learning organisation and had created their own ‘in house’ learning programme for all practice staff. The workshops, based around identified priorities from the practice development plan, provided a forum for open discussion, the sharing of ideas and creating change to be embedded in the practice culture.  This had given each member of the practice team the opportunity to contribute and their personal involvement is written up in their personal development plan and discussed at appraisal.
• The practice had provided a series of tutorials and workplace opportunities to develop insights into leadership development across the practice team. The aim was to allow staff to develop insights into personal capacity and encourage a critical eye to seek new improvements and make recommendations for change.  Areas of practice that had been discussed and improved through this method included; continuity of care in home visits and patient access to appointments.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 5 August 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 higher than the CCG and national average. For example, the percentage of patients with diabetes, on the register who have had an influenza immunisation in the preceding 12 months was 100% (CCG average 96%, national average 94%).
• 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 5 August 2016

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 A&E attendances. Immunisation rates were relatively high 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 percentage of women aged 25-64 whose notes record that a cervical screen test has been performed in the preceding 5 years was 96% (CCG average, 89%, national average, 82%).
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives and health visitors. 
• The practice was working in partnership with Ecclesfield School to promote careers in all areas and at all levels within the NHS. There were four stages to this programme which culminated in three practice placement opportunities for students who had shown an interest in working in the NHS.

Updated 5 August 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 accessible with provision for hearing impairment and equipped with additional examination rooms to allow older people extra time to prepare for intimate examinations

Updated 5 August 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 5 August 2016

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

• 90% of patients diagnosed with dementia who had  had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the CCG average of 86% and the national average of 84%.
• Performance for mental health related indicators was above the CCG and the national average. For example, the percentage of patient with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan documented in the record in the preceding 12 months was 97% (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 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 5 August 2016

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 offered longer appointments for patients with a learning disability.
• In order to optomise access to the Annual Health Check for patients with a learning disability, the practice had developed a unique template in conjunction with service users. This colourful template encouraged and enabled this group of patients to think about their health in a proactive way prior the their appointment.
• 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.