Reedyford Health Care

Updated 31 May 2016

Reedyford Health Care has a personal medical services (PMS) contract with NHS England to provide primary care services for 10,615 patients in the town of Nelson in East Lancashire. There is also a branch surgery in the nearby smaller town of Barrowford. The main practice site is located in Yarnspinners Primary Health Care Centre which is owned by Community Health Partnership (CHP). The site also hosts four other practices and a variety of community services including podiatry, dietician and health visitor clinics. This property is maintained and serviced by NHS Property Services Ltd. The Barrowford branch site is owned and maintained by the partners of Reedyford Health Care.

The practice has six GP partners, two female and four male, as well as one salaried GP and is a training practice. The nursing team comprises of one nurse practitioner, four nurses and two health care assistants. They are supported by a practice manager and team of 14 support staff.

The practice is open Tuesday to Friday 8am until 6.30pm and Mondays from 8am until 8.30pm. Appointments are available throughout the day, from 8.30am until 6.30pm each afternoon, with extended hours on Monday evenings at Yarnspinners Health Centre and nurse appointments are available one Saturday morning each month at Barrowford branch surgery.

2011 census data shows a varied practice population with around 10-12% Asian patients and 80% white British. The practice has also seen an increase in eastern European patients in the last few years. Age ranges are broadly in line with national averages though the practice has more 0-9 year olds than average. Male and female life expectancy is in line with East Lancashire Clinical Commissioning Group (CCG) and national averages.

Information published by Public Health England rates the level of deprivation within the practice population as three on a scale of one to 10 (level one represents the highest levels of deprivation and level 10 the lowest). East Lancashire generally has a higher prevalence of Chronic Obstructive Pulmonary Disease (COPD, a disease of the lungs), smoking and smoking related ill-health, cancer, mental health and dementia than national averages.

The practice was previously inspected in September 2013, and was found to be meeting all required standards.

Updated 31 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Reedyford Health Care on 14 April 2016. Overall the practice is rated as good.

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

• The practice sought out innovative methods to share health information and health promotion campaigns through Facebook and Twitter.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Patients were able to get urgent appointments but said they sometimes found it difficult to make an appointment with a named GP. The practice was actively trying to address patient access.
• 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 offered drop in sexual health clinics and childhood vaccinations outside the core working day.
• The practice identified that not all external test results were being recorded on patient medical notes during the inspection, for two out of 151 patients who were prescribed warfarin. The practice began addressing this whilst we were on site.

We saw one area of outstanding practice:

The practice had begun using social media to communicate with patients and reached a wide audience through Facebook and Twitter. For example, The practice had 1,800 followers on Twitter and its Facebook page showed over 2,000 views in one week. A variety of health promotion campaigns were being shared with a large group of patients in this way. A cardiac rehabilitation video which explained the signs and symptoms of cardiac arrest had been shared, this had reached over 10,000 people through Facebook groups.

The areas where the provider should make improvement are:

• Review procedures to update patient medical records consistently with information from other providers, including clinical information and test results.
• Review access to emergency drugs to ensure these are easily accessible in an emergency and review the signage around the emergency oxygen in the reception area.
• Review access to complaints leaflets so patients can access these without requesting them from reception staff.
• Conduct annual significant event reviews to ensure all learning has been implemented.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 31 May 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.
• Data showed the practice was performing in line with national averages for the indicators relating to patients with diabetes. For example, 98% of patients with diabetes received an influenza immunisation in the previous flu season compared to 94% nationally and 89% had a recent blood pressure test which was within a normal range compared with 78% nationally.
• Longer appointments and home visits were available when needed.
• The practice worked closely with the community diabetes nurse specialist. Two practice nurses and one GP were trained to initiate insulin prescribing and worked closely with the community specialist diabetes nurse in caring for patients with more complex diabetes.
• 93% of patients with chronic obstructive pulmonary disease (COPD, a lung disease) had a full annual review compared with a national average of 90%.
• 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 31 May 2016

The practice is rated as good for the care of families, children and young people, with outstanding as responsive for this population group.

• 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.
• 86% of women aged 25-64 had a cervical screening test carried out in the previous 5 years compared with 82% nationally.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• Childhood immunisations were in line with or slightly above local CCG averages. These were offered once a month on Saturday mornings as well as during the week for parents who found it easier to attend outside the working week.
• The practice offered drop in sexual health clinics at a time suitable for young people to call in on Monday evenings. Emergency and long-term contraceptive advice and fitting was available.
• The practice nurses offered travel advice, vaccinations, and the practice was registered as a yellow fever centre.
• The practice engaged with over 2,000 patients via social media sharing health information and campaigns via Facebook and Twitter.
• Staff had all completed basic life support training for children and new-born babies as well as additional safeguarding training to identify patients at risk of female genital mutilation.

Updated 31 May 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.
• 74% of patients over 65 years old had received a seasonal flu vaccination compared with the national average of 73% in 2013-14.

• The practice worked closely with a tele-hub service at Airedale Hospital which provided immediate telephone support to care homes for older patients.

Updated 31 May 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.
• The practice had adjusted opening hours and 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 reflected the needs for this age group.
• The practice offered extended hours access on Monday evenings and Saturday mornings to patients who could not attend during the working day, as well as telephone appointments where appropriate.
• The practice embraced social media and information technology to engage with engage with over 2,000 patients sharing health information and campaigns.
• Telephone appointments and electronic prescription services were available within the practice.

Updated 31 May 2016

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

• 95% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which higher than the national average of 89%.
• 83% of patients with dementia had a face to face review, similar to the national average of 84%.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• Counselling and local well-being services were available in the practice building.
• The practice carried out advance care planning for patients with dementia.
• The practice aimed for early diagnosis and support for patients with depression and anxiety.
• The practice had informed patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 31 May 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice allocated a GP and the practice triage nurse to patients who were terminally ill, in order to ensure good continuity of care during a difficult time for patients and their families.
• 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 multi-disciplinary teams in the case management of vulnerable people, and actively identified vulnerable patients who needed greater health care support.
• The practice informed vulnerable patients about how to access a range support groups and voluntary organisations.
• Staff actively identified and reported potential incidents 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.
• The practice referred patients to the local well-being service for support with social needs when appropriate. This service was available most days within the practice building.
• The practice referred patients with additional social and health needs to the integrated neighbourhood team.
• The practice offered joint clinics with the local drug and alcohol service.
• The practice identified individuals who were particularly vulnerable, and kept records of additional care, support and treatment for these patients.