Hyde Park Surgery

Updated 28 December 2016

Hyde Park Surgery is situated at Woodsley Road, Leeds LS6 1SG. The practice is situated just under two miles north west of Leeds City Centre. The surgery is housed in purpose built premises, built approximately 40 years ago, and refurbished around 18 years ago. It is a single storey building. The practice has parking facilities, disabled access, and is accessible by public transport.

There are currently 9,981 patients on the practice list. The age profile of the practice shows a significantly higher than average number of people in the 15 to 34 year age group, and a significantly lower than average number of people in the 45 to 85 year age group. Public Health England national general practice profile shows the ethnic background of the patients as 18% Asian, 5% black, 2% other non-white ethnicity, and 5% mixed ethnicity. Eleven percent of the patient group are unemployed compared to the CCG and national average of 5%.

The practice provides Personal Medical Services (PMS) under a locally agreed contract with NHS England. They offer a range of enhanced services such as:

• Extended hours access

• Online patient access

• Enhanced services for patients with learning disabilities

• Childhood vaccination and immunisations

• Enhanced services to support patients with dementia

The practice has four GP partners, three female and one male. In addition there are two male salaried GPs. The clinical team is completed by three female practice nurses and two female health care assistants.

The clinical team is supported by a practice manager, assistant practice manager, reception supervisor and a range of administrative and reception staff. At the time of our visit the practice manager was absent from her role. The assistant practice manager was fulfilling the role, supported by the lead GP.

The practice is classed as being within the fourth most deprived decile in England. People living in more deprived areas tend to have greater need for health services.

The average life expectancy for patients at the practice is 80 years for women and 75 years for men. The CCG average is 82 years and 78 years respectively; and the national average 83 years and 79 years respectively.

The practice is open between 8am and 8pm Monday to Friday and between 8am and 4pm Saturday and Sunday as part of a reciprocal agreement delivered via a locality ‘hub’.

Appointments with GPs are as follows:

• Monday 8am to 11.50am and 2.15 to 7.20pm

• Tuesday from 8am to 11.20am and 1pm to 7.20pm

• Wednesday from 8.30am to 11.50am and 1pmto 7.50pm

• Thursday from 8am to 11.50am and 2pm to 7.50pm

• Friday from 8am to12.30pm and 2pm to 7.20pm

• Saturday and Sunday 8am to 11.20am and 12.15 to 3.35pm.

Weekly clinics are held which include asthma, diabetes and childhood immunisation clinics.

Out of hours care is provided by Local Care Direct which is accessed by calling the surgery telephone number, or by calling the NHS 111 service.

Updated 28 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hyde Park Surgery on 29 November 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.
• We saw that one member of staff had been employed without references having been obtained prior to appointment.
• 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.
• In the most recent patient satisfaction survey, 100% of patients said they had confidence and trust in the last GP they saw compared to the CCG average of 97% and the national average of 95%.
• 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 was open 8am to 8pm Monday to Friday. In addition patients were able to access appointments on Saturday and Sunday between 8am and 4pm, delivered via a reciprocal local ‘hub’ arrangement. Appointments could be booked up to three months in advance. In addition appointments were available on the day for those patients with more urgent needs.
• 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 GP partners and 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 provided evidence to show that they had reduced opioid prescribing by 10% within a four month period supported by the West Yorkshire ‘Campaign to Reduce Opioid Prescribing’ (CROP) project.

However the provider should:

• Review their recruitment processes and take steps to obtain appropriate references for all staff before appointment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 December 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.

• 90% of patients with chronic obstructive pulmonary disorder (COPD) had received an influenza immunisation in the preceding year, compared to 98% locally and 97% nationally. COPD is a term used for a range of non-reversible lung disorders which impair normal breathing.

• Longer appointments and home visits were available when needed.

• The practice had recently introduced the ‘Year of Care’ model for diabetic patients. This encouraged patients to set their own goals for managing their condition, and actively involved them in their own care plans.

• The practice told us they were planning to introduce a system where the patient was invited to attend one appointment, where all their conditions were reviewed at the same time.

• The practice had participated in the University of Leeds led ‘Aspire’ project. This aimed to improve the identification and management of patients with Type two diabetes.

• 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 28 December 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 accident and emergency (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, and described examples to demonstrate this.

• 89% of eligible women had received a cervical screening test in the preceding five years which is higher than the CCG average of 79% and national average of 82%.

• The practice was open between 8am and 8pm on Monday to Friday and between 8am and 4pm on Saturday and Sunday provided by a reciprocal arrangement via a locality ‘hub’. Baby changing facilities were available. Staff told us a room could be provided for breast feeding mothers if requested.

• We saw a handwritten testimonial provided by the midwife attached to the practice. This described the practice as supportive and effective, with good communication between practice staff and midwife.

• Meetings with health visitors were held at irregular intervals due to recent changes in the health visiting service. Practice staff told us the health visitor updated the practice on a monthly basis on children who were subject to child safeguarding plans. These are plans where health, social care and other services work together to keep children safe. At the time of our visit the practice had nine children on a child safeguarding plan.

Updated 28 December 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.

• GPs worked with district nursing teams to regularly review the needs and plan care for older people with more complex needs.

• The practice had identified 2% of their population at greater risk of unplanned hospital admission. Those patients who had attended accident and emergency or had a hospital admission were reviewed on a monthly basis, and following discharge from hospital were contacted by the GP within 48 hours of discharge. Their needs were reviewed, and any necessary changes to medications or care plans were made

Updated 28 December 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 acknowledged. The practice was open between 8am and 8pm Monday to Friday, and between 8am and 4pm on Saturday and Sunday provided by a reciprocal arrangement via a locality ‘hub’. Working age people were offered early morning and evening appointments to meet their needs.

• The practice had a high proportion of young people registered, many of whom were students. The practice had links with the student halls of residence to support the welfare of students. The practice attended the university during ‘Fresher’s Week’ to encourage registration with local practices.

• The practice offered online access to book or cancel appointments, request repeat prescriptions or access health information. We saw that 3,130 patients (31% of the practice population) had registered for online access.

• The practice sent text reminders to patients, advising them of appointment times.

Updated 28 December 2016

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

• 100% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is higher than local and national averages of 87% and 84% respectively

• 85% of patients with schizophrenia or other psychoses had had their blood pressure recorded in the preceding 12 months, which is lower than the local average of 88% and the national average of 89%.

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

• The practice had access to ‘Improving Access to Psychological Therapies’ (IAPT) services. Patients were able to self-refer, or be referred by a clinician.

• The practice carried out advance care planning for patients with dementia.

• The practice gave patients experiencing poor mental health information about how to access various support groups and voluntary organisations.

• The practice followed up patients who had attended accident and emergency where they may have been experiencing poor mental health.

Staff demonstrated they were aware of how to support patients with mental capacity issues. They had received appropriate training via their protected learning time arrangements

Updated 28 December 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 more complex needs.

• The practice told us that a high proportion of their patients did not have English as a first language. A telephone interpreter service was used regularly. Longer appointments were offered for these patients.

• The practice had input into two local bail hostels, and a number of women’s refuges. In collaboration with other professionals they offered support to this group of patients.

• A proportion of the practice population had alcohol or substance misuse dependency problems. The practice hosted an addiction therapist clinic weekly delivered by a local service. The practice provided evidence to show that they had reduced opioid prescribing by 10% within a four month period supported by the West Yorkshire ‘Campaign to Reduce Opioid Prescribing’ (CROP) project.

• Clinical staff were trained to provide ‘brief interventions’ for patients with alcohol related issues.

• The practice participated in the local blood borne viruses pilot. Newly registered patients and those identified as vulnerable were offered screening for HIV, Hepatitis B and C.

• Staff demonstrated they knew how to recognise signs of abuse in vulnerable adults and children. They 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.