Dykes Hall Medical Centre

Updated 22 November 2016

Dykes Hall Medical Centre is located in a purpose built health centre in the S6 district of Sheffield and accepts patients from the surrounding area. The practice has a branch site two miles away named Deer Park Surgery which was visited as part of the inspection. Public Health England data shows the practice population is comparable to others in the area with a slightly a higher than average number of patients aged over 45 years old compared to the England average. The practice catchment area has been identified as one of the six least deprived areas nationally.

The practice provides Primary Medical Services (PMS) under a contract with NHS England for 9,700 patients in the NHS Sheffield Clinical Commissioning Group (CCG) area. It also offers a range of enhanced services such as minor surgery, anticoagulation monitoring and childhood vaccination and immunisations.

Dykes Hall Medical Centre has five GP partners (three female, two male), two salaried GPs (one male, one female), three practice nurses, two phlebotomists, a practice manager and an experienced team of reception and administration staff. The practice is a teaching practice for GP registrars and foundation doctors.

The practice and the branch site are both open 8.30am to 6pm, Monday to Friday, with the exception of Thursdays when the practice closes at 1pm. The Sheffield GP Collaborative provides cover when the practice is closed on a Thursday afternoon. Extended hours are offered between 8am and 10.15am on a Saturday morning at the main site. Morning and afternoon appointments are offered daily Monday to Friday with the exception of Thursday afternoon when there are no afternoon appointments.

When the practice is closed between 6.30pm and 8am patients are directed to contact the NHS 111 service. The Sheffield GP Collaborative provides cover when the practice is closed between 8am and 6.30pm. For example, between 8am and 8.30am. Patients are informed of this when they telephone the practice number.

As part of the Care Quality Commission (Registration) Regulations 2009: Regulation 15, we noted the GP partners registered with the Care Quality Commission as the partnership did not reflect the GP partners at the practice. The registered manager information was incorrect. However, we noted forms had been submitted to CQC prior to the inspection to rectify this.

Updated 22 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dykes Hall Medical Centre on 19 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 with the exception of immunity status checks of clinical staff.
• 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.
• Patients said they found it easy to make a same day urgent appointment although it was sometimes difficult to make a routine appointment.
• 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 areas where the provider should make improvement are:

• Maintain a record of the immunity status of all clinical staff as specified in the national Green Book (immunisations against infectious disease) guidance for healthcare staff.

• Review the system for checking consumables are within their expiry date throughout the practice and the branch site.

• Consider the layout of the reception area at the main site and review ways to reduce the potential for conversations held at the reception being overheard in the waiting area. 

• Review the patient survey results to address low satisfaction scores with telephone and appointment access.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 22 November 2016

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

• The GPs had lead roles in long term condition management and patients at risk of hospital admission were identified as a priority.

• 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. The practice was looking to develop the new practice nurses to lead in this role and had arranged for them to attend a training course.

• 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. For example, the diabetic specialist nurses.

Updated 22 November 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.

• Staff told us that children and young people were treated in an age-appropriate way and were recognised as individuals.

• Data showed 92% of women eligible for a cervical screening test had received one in the previous five years higher than the national average of 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 held safeguarding meetings with health visitors and midwives every six weeks at the practice.

Updated 22 November 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 provided medical care and weekly routine GP visits to patients who resided in a local care home.

• The percentage of patients aged 65 or over who received a seasonal flu vaccination was 73%, which was comparable to the national average of 73%.

Updated 22 November 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 offered pre-booked appointments on a Saturday morning at the practice and weekend and evening appointments at a local practice through the Sheffield satellite clinical scheme.

• 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 22 November 2016

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

• Of those patients diagnosed with dementia, 86% had received a face to face review of their care in the last 12 months, which is comparable to the national average of 84%.

• Of those patients diagnosed with a mental health condition, 96% had a comprehensive care plan reviewed in the last 12 months, which is higher than the national average of 88%.

• The practice regularly worked with multidisciplinary 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 with dementia.

• The practice had advised 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.

• The practice hosted Improving Access to Psychological Therapies Programme (IAPT), a counselling service to support patients’ needs.

Updated 22 November 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 those with a learning disability.

• The practice offered longer appointments for patients with a learning disability and those who required one.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients and 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.