Highfield Surgery

Updated 7 February 2017

Highfield Surgery is a GP practice, which provides primary medical services to approximately 3,407 patients predominately living within the Highfield area and surrounding areas. Leicester City Clinical Commissioning Group (LCCCG) commission the practice’s services.

The practice has two GP partners (one male and one female) and two long-term locum GPs (both male). The nursing team consists of two part-time long-term locum practice nurses. They are supported by a Practice Manager, who also has health care assistant responsibilities and a team of reception staff and administrative staff.

The practice is open between 8am and 6.30pm Monday to Friday, however closes at 1pm on Thursdays. Extended hours appointments are offered between 6.30pm and 8.30pm on Mondays. In addition to pre-bookable appointments that can be booked up to two weeks in advance, urgent appointments and telephone consultations are also available for people that need them.

Patients can access out of hours support from the national advice service NHS 111. The practice also provides details for the nearest urgent care centres, as well as accident and emergency departments.

Updated 7 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Highfield Surgery on 17 November 2016. Overall the practice is rated as good.

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

• There was an effective system in place for reporting and recording significant events and lessons were shared to make sure action was taken to improve safety in the practice.

• There was a system in place to review and action MHRA alerts, however we noted not all alerts from the Department of Health were actioned accordingly. For example, estates and facilities alerts.

• The practice had systems, processes and practices in place to keep patients safe and safeguarded from abuse.

• There was a system in place to monitor the use of prescription forms, but not prescription pads.

• Most risks to patients were assessed and managed. However, not all identified actions were carried out.

• Staff assessed needs and delivered care in line with current evidence based guidance. Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were above average compared to the national average in several areas.

• Staff had the skills, knowledge and experience to deliver effective care and treatment.

• There was evidence of appraisals for all staff.

• Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs.

• Staff were aware of their responsibilities in relation to the Mental Capacity Act and had undergone training.

• The practice promoted health education and self-management of medical conditions for patients to live a healthier lifestyle.

• Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.

• Data from the national GP patient survey showed patients rated the practice higher than others for several aspects of care.

• Information for patients about the services available was easy to understand and accessible.

• We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.

• Practice staff reviewed the needs of its local population and engaged with the NHS England Area Team and Clinical Commissioning Group to secure improvements to services where these were identified.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• Information about how to complain was available and easy to understand and evidence showed the practice responded quickly to issues raised.

• The practice had a vision to deliver quality care and promote good outcomes for patients, within a family practice environment.

• There was a leadership structure and staff felt supported by management. The practice had a number of policies and procedures to govern activity.

• There was a governance framework which supported the delivery of the strategy and good quality care.

• The practice sought feedback from staff and patients, which it acted on.

The areas where the provider should make improvement are:

• Document the flushing of the taps and water temperatures.

• Review the monitoring system of prescription pads.

• Review all alerts and ensure action is taken as appropriate.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 February 2017

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

• GPs had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• 92% of patients with diabetes had their last blood pressure reading in the preceding 12 months of 140/80 mmHG or less, compared to the CCG average of 74% and national average of 78%.

• 89% of patients with diabetes had their last cholesterol check within the preceding 12 months of 5 mmol/l or less, compared to the CCG average of 79% and national average of 80.2%.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and were offered 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.

• Care plans were in place for patients with multiple conditions to ensure they received the appropriate care, treatment and support from relevant health and social care providers.

Updated 7 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.

• The practice’s uptake for the cervical screening programme was 65%, which was comparable to the CCG average of 68% and the national average of 74%.

• Appointments were available outside of school hours.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

• Family planning services were provided at the practice.

Updated 7 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.

• The practice was able to refer patients to other health and social care providers including a Care Navigator who could assess and refer patients to physiotherapy and occupational therapy.

Updated 7 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.

• The practice had online facilities for patients to book appointments and request repeat prescriptions.

• A full range of health promotion and screening was offered that reflected the needs for this age group.

Updated 7 February 2017

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

• 91% of patients with a diagnosis of dementia had their care plan reviewed in a face-to-face meeting in the preceding 12 months, compared to the CCG average of 86% and national average of 84%.

• 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 had told patients experiencing poor mental health about how to access various support groups and voluntary organisations, including Open Mind.

• 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 7 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 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 and were aware of their responsibilities.