Archived: Blue Dykes Surgery Also known as Drs Wayman & Shell

Updated 29 July 2016

Blue Dykes Surgery provides primary medical services to approximately 8600 patients through a Primary Medical services (PMS) contract. Services are provided to patients in a purpose built practice which has been recently renovated in the town of Clay Cross, Chesterfield.

The practice population live in an area of average deprivation and the income deprivation levels affecting children and older people is also in line with the England average.

The practice team comprises of two GP partners (one male and one female), a salaried female GP (currently on maternity leave), and a team of healthcare assistants, advanced nurse practitioners, practice nurses, a community psychiatric nurse and two practice pharmacists. The clinical team is supported by a practice manager, assistant practice manager and a team of reception and administrative staff.

The practice opens from 8am to 6.30pm Monday to Friday. Morning appointments are available daily from 8.40am to 12pm. Afternoon appointments are available from 2.30pm to 6pm. The practice runs an evening session once a week from 6.30pm to 8.30pm on alternating Wednesdays and Thursdays.

The practice has opted out of providing out-of-hours services to its own patients. This service is provided by Derbyshire Health Unites (DHU).

Updated 29 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Blue Dykes Surgery on 8 June 2016. Overall the practice is rated as good.

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

• Significant improvements had been made to the systems and processes in place which was highlighted following our initial inspection in August 2015. This included arrangements for delivering safe care and treatment and improved governance arrangements.

• Risks to patients and staff were well monitored and regular audits carried out to ensure policies reflected the latest guidance.

• The practice had 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.

• An innovative approach to staffing had established an effective clinical team which had areas of specialties allowing the most appropriate clinician to care for patients. For example, the practice employed a community psychiatric nurse, two pharmacists and advanced nurse practitioners in addition to practice nurses and a health care assistant.

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

• The practice undertook clinical audits to review patient care and took action to improve services as a result. A plan was in place for future audits and all staff were actively involved in driving improvement.

• Patients told us that access to GP appointments could sometimes be difficult and this was reflected in the results from the national GP patient survey.

• Information about services and how to complain was available. The practice sought patients’ views about improvements that could be made to the service directly and through the patient participation group (PPG).

• 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.

• In spite of the improvements there were some areas where governance and oversight needed to be strengthened, for example ensuring staff training the practice deemed mandatory had been completed by all staff.

• The practice planned and co-ordinated patient care with the wider multi-disciplinary team to deliver effective and responsive care for patients with complex health needs and / or living in vulnerable circumstances.

• The practice had an active PPG and worked with them to review and improve services for patients.

However there were areas where improvements should be made:

• Ensure an effective system is in place to ensure training, which the provider deemed as mandatory, is completed by all staff.

• Ensure patient experience data (including access to appointments) continues to be reviewed, monitored and acted upon to continually drive service improvement.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 29 July 2016

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

• The practice was in line with the local and national averages for its performance for the care of patients with long-term conditions. For example:

  • The percentage of patients with a lung disease who had a review undertaken in the preceding 12 months was 87% compared to a national average of 90%.

• Longer appointments and home visits were available when needed.

• Nurses had specialist training in chronic disease management to enable them to support patients with long term conditions.

• All patients with a diagnosis of cancer were given a named GP to ensure continuity of care

Updated 29 July 2016

The practice is rated as good for the care of families, children and young people.

• The practice worked closely with the local health visitors in the care of children and young people.

• Immunisation rates were in line with the CCG average for all standard childhood immunisations.

• Appointments were available outside of school hours and the premises were suitable for children and babies. Urgent appointments were always available on the day.

• The practice employed community psychiatric nurse was able to take on patients from internal referrals in regards to anxiety and depression including post-natal depression.

Updated 29 July 2016

The practice is rated as good for the care of older people.

• The practice offered personalised care to meet the needs of older people in its population.

• Staff were responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• The care coordinator and practice staff worked effectively with multi-disciplinary teams to identify patients at risk of admission to hospital and to ensure their needs were met.

• Monthly meetings were held with the wider multi-disciplinary team to support patients to live in their own homes and ensure they were kept safe, and had their individual needs met. A practice nurse made frequent visits to patients in their homes and the local nursing and residential homes to carry out both urgent appointments as well as routine health reviews where appropriate.

• For patients requiring a medicines review, the practice pharmacists would arrange a home visit if the patient was unable to get to the surgery.

Updated 29 July 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. This included access to telephone appointments and the availability of extended hours appointments one evening a week.

• The practice offered online services such as electronic prescriptions and GP appointments were offered through the online booking system.

• Health promotion and screening was provided that reflected the needs for this age group. The practice was in line with the CCG for health checks. For example, the practice had screened 64% of patients aged between 60 and 69 years for bowel cancer, which was above the CCG average of 60%.

Updated 29 July 2016

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

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

• Staff had a good understanding of how to support people with mental health needs and dementia.

• The practice employed community psychiatric nurse was able to see patients for extended appointments and at their home if appropriate. Follow up appointments were organised to establish a supportive mental health service to the patients.

• Patients who are not able to make their own decision were appropriately assessed to ensure best interest decisions were made.

Updated 29 July 2016

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

• The practice offered longer appointments for people with a learning disability in addition to offering other reasonable adjustments. Health checks were also offered to patients with a learning disability.

• The safeguarding lead GP regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• The practice offered patients who placed a greater demand on the local healthcare team, and practice staff, a weekly appointment which they could attend without a reason.This had been anecdotally shown to reduce the number of appointments these patients required on both local emergency departments and other providers of care.

• 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.

• For patients on the end of life register, a dedicated phone line was available which ensured calls were answered promptly and appropriate care was organised for patients.

• The practice’s computer system alerted GPs if a patient was also a carer. A total of 341 carers were registered with the practice and this equated to 4% of the patient list.