Ireland Wood Surgery

Updated 3 February 2017

Ireland Wood Surgery is located on Iveson Approach, Ireland Wood, Leeds, LS16 6FR. There is also a branch site, The New Croft Surgery which is located on Broadgate Lane, Horsforth, Leeds, LS18 4SE. Both sites operate from purpose built buildings and have parking available for staff and patients. We visited both sites as part of our inspection.

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

The service is provided by twelve GP partners (seven male and five female) and eight salaried GPs (female). The practice also has two advanced nurse practitioners, two senior practice nurses, four practice nurses, a clinical pharmacist, five health care assistants and two clinical care co-ordinators. The clinical staff are supported by a practice manager, an assistant practice manager and an experienced team of administrative and reception staff.

The practice is a training practice for GP Registrars. GP Registrars are fully qualified doctors training to become a GP through a period of working and training at the practice.

The practice serves a population of 24,737 patients who can access a number of clinics for example; an eye clinic, minor surgery and child health and vaccinations.

Both sites are open between 7am and 7pm Monday to Friday with a range of appointments being offered during these hours. In addition the practice also hosts an extended hours hub in conjunction with other local practices. The hub services were open from 8am until 4pm on Saturday and Sunday.

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 3 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Ireland Wood Surgery on 20 October 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 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.
• 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.
• The practice had a lead GP for the care homes in the area who worked closely with care home staff and provided regular sessions at each home. The GP was supported by the practice pharmacist. 
• The practice offered a dedicated surgery for students in conjunction with the university nurse. This service was offered for one hour on Monday, Wednesday, Thursday and Friday.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 February 2017

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.
• The practice ran specialist clinics for asthma, COPD and diabetes.
• The practice had adopted the Year of Care model for management of patients with diabetes. The Year of Care model was aimed at encouraging patients with diabetes to understand their condition and select their own personal health and lifestyle targets.
• The practice had identified patients with multiple co-morbidities using a risk stratification tool. These patients were supported by the clinical care co-ordinators with input from their named GP. This included monthly meetings to review patients and identify any themes in order to better tailor care to suit their individual needs.
• 92% of patients with diabetes, on the register, had a record of a foot examination and risk classification. This was better than the CCG average of 88% and national average of 89%.
• 98% of patients with diabetes, on the register, had received an influenza immunisation in the preceding eight months.
• Longer appointments and home visits were available when needed.
• The GPs and nursing staff worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 3 February 2017

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 practice’s uptake for the cervical screening programme was 86%, which was better than the CCG average of 79% and national average of 81%.
• The practice provided prenatal advice, antenatal and post-natal care with the support of the community midwifes.
• The practice offered family planning services included coils and implants. In addition the practice also offered sexual health screening.
• 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, health visitors and school nurses.

Updated 3 February 2017

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.
• All patients aged 75 years and over had a named GP with health checks available upon request. 
• The practice worked with a range of local voluntary services to support the older population.
• The practice employed two care co-ordinators to provide support to patients. This included assessing patients at home and liaising with other services to provide the best support and care.
• The practice had a lead GP for the care homes in the area who worked closely with care home staff and provided regular sessions at each home. The GP was supported by the practice pharmacist. 

Updated 3 February 2017

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. For example; the practice offered a dedicated surgery for students in conjunction with the university nurse.
• 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 and had worked with the patient participation group to promote this. This has resulted in 20% of the patient list being registered to use online services.
• Patients over the age of 40 were able to access health checks at the practice and the uptake in the previous year was 42%.

Updated 3 February 2017

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

• Overall performance against the dementia indicators was better than the CCG and national average. However; only 81% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was lower than the CCG average of 87% and national average of 84%.
• 89% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive care plan documented in the record, in the preceding 12 months. This was better than the CCG average of 89% and same as the national average.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice carried out advance care planning for patients 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 dementia.

Updated 3 February 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 offered longer appointments for patients with a learning disability, carried out health checks and ensured appropriate care plans were in place.
• 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.