Vesper Road Surgery

Updated 28 December 2016

Vesper Road Surgery is a member of the Leeds West Clinical Commissioning Group (CCG). General Medical Services (GMS) are provided under a contract with NHS England. They also offer a range of enhanced services, which include:

• Childhood vaccination and immunisations

• The provision of influenza and pneumococcal immunisations

• Facilitating timely diagnosis and support for patient with dementia

• Extended hours access

• Improving online access

Vesper Road is located at 43 Vesper Road, Leeds LS5 3QT which is in a suburb of Leeds, with a branch surgery located at Morris Lane, Leeds.

The practice is situated in an urban area of Leeds in the lowest 30% of deprived areas in England. There are facilities for people with disabilities and all patients areas are on the ground floor. There are no car parking facilities on site, but road side parking is available.

The practice has a patient list size of 6186 which is made up of predominantly white British, with an almost 50:50 ratio of male and female patients.

There are four GP partners, one female and three male, who are supported by two practice nurses. There is a practice manager and a team of administration and reception staff. The practice also has the support of CCG employed medicines management pharmacists.

The practice is open between 8am to 8pm Monday and Thursday and 7am to 7pm Fridays at Vesper Road, and between 9am and 6pm Monday to Friday at Morris Road Surgery. At weekends on Saturday and Sunday from 8am to 4pm, the practice provides cover arrangement in partnership with 12 other neighbourhood GPs, through a hub arrangement. When the practice is closed out-of-hours services are provided by Local Care Direct, which can be accessed via the surgery telephone number or by calling the NHS 111 service.

The practice has good working relationships with local health, social and third sector services to support provision of care for its patients. (The third sector includes a very diverse range of organisations including voluntary, community, tenants’ and residents’ groups.)

We were informed that the practice did not use salaried or locum doctors and had not used a locum doctor for eight years, providing medical cover arrangements by the four partners.

Updated 28 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Vesper Road Surgery on 14 September 2016. Overall the practice is rated as good for providing safe, effective, caring, responsive and well-led care for all of the population groups it serves.

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

• The ethos and culture of the practice was to provide good quality service and care to patients.

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

• Patients’ needs were assessed and care was planned and delivered following best practice guidance.

• The practice had good facilities and was well equipped to treat and meet the needs of patients. Information regarding the services provided by the practice and how to make a complaint was readily available for patients.

• Patients we spoke with were generally positive about access to the service. They said they found there was continuity of care and urgent appointments were available on the same day as requested.

• The practice of, and complied with, the requirements of the duty of candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment.)

• The partners a culture of openness and honesty which was reflected in their approach to safety.

• Risks to patients were assessed and well managed.

• There were comprehensive safeguarding systems in place; particularly around vulnerable children and adults.

• The practice sought patient views about how improvements could be made to the service, through the use of patient surveys, the NHS Friends and Family Test and the patient participation group.

• There was a clear leadership structure.

We saw an area of outstanding practice:

• The practice linked with consultant colleagues for rapid opinions by using a derma scope which was able to send pictures of skin lesions to specialists for opinions, and was able to send electronically electro cardio graphs by a ‘cloud’ to heart specialistfor accurate reading.These services ensured that patients had rapid specialist’s assessments without the need to attend hospital in many cases. Since January 2016 37 patients had benefited from the dermatasope remote assessment and in the same period 52 from the remote ECG assessment.

However there were areas of practice where the provider should make improvements:

• The practice should ensure that clinicians administering immunisations receive at least the minimum training updates.

• The practice should reconsider its Infection Prevention and Control action plan and in particular the maintenance of records for the cleaning of individual pieces of clinical equipment.

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.

• The GPs had lead roles in the management of long term conditions and were supported by the nursing staff. Annual reviews were undertaken to check patients’ health care and treatment needs were being met. Holistic reviews were undertaken with patients who had several co-morbidities, which avoided the need for multiple appointments.

• The practice maintained a register of patients who were at high risk of an unplanned hospital admission. Care plans and support were in place for these patients.

• 75% of patients diagnosed with asthma had received an asthma review in the last 12 months (CCG and national averages of 75%).
• 88% of patients diagnosed with chronic obstructive pulmonary disease (COPD) had received a review in the last 12 months (CCG and national average 90%).
• The practice identified those patients who had complex needs and life limiting conditions and ensured they were on the palliative care register.

Updated 28 December 2016

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

• The practice worked with midwives, health visitors and school nurses to support the needs of this population group. For example, the provision of ante-natal, post-natal and child health surveillance clinics.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk.

• There was a ‘did not attend’ (DNA) protocol in place to follow up any children and young people who failed to attend a hospital appointment or immunisations at the practice.

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

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• Immunisation rates were with the CCG and national rates for all standard childhood immunisations.

• Sexual health, contraceptive and cervical screening services were provided at the practice.

• 90% of eligible patients had received cervical screening (CCG average 79% and national average 82%).

• Appointments were available with both male and female GPs.

Updated 28 December 2016

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

• The practice provided proactive, responsive and care to meet the needs of the older people in its population.

• The practice worked closely with other health and social care professionals, such as the district nursing and local neighbourhood teams, to ensure housebound patients received the care and support they needed.

• The practice participated in Leeds West Clinical Commissioning Group (CCG) initiatives to reduce the rate of elderly patients’ acute admission to hospital.

• Patients who were considered to be at risk of frailty were identified and support offered as appropriate

• Care plans were in place for those patients who were considered to have a high risk of an unplanned hospital admission and patients were reviewed as needed.

• Health checks were offered for all patients over the age of 75 who had not seen a clinician in the previous 12 months.

• Patients were signposted to other local services for access to additional support, particularly for those who were isolated or lonely.

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 these patients 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 provided extended hours appointments one evening per week, telephone consultations, online booking of appointments and ordering of prescriptions.
• The practice offered a range of health promotion and screening that reflected the needs for this age group.
• Health checks were offered to patients aged between 40 and 74 who had not seen a GP in the last three years.
• Students were offered public health recommended vaccinations prior to attending university.
• Travel health advice and vaccinations were available.

Updated 28 December 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 multidisciplinary teams in the case management of people in this population group, for example the local mental health team.
• Patients and/or their carer were given information on how to access various support groups and voluntary organisations.
• 100% of patients diagnosed with dementia had received a face to face review of their care in the preceding 12 months (CCG average 83%, national average 84%).
• 100% of patients who had a complex mental health problem, such as schizophrenia, bipolar affective disorder and other psychoses, who had a comprehensive, agreed care plan documented in their record in the preceding 12 months (CCG and national averages of 88%).
• Staff had a good understanding of how to support patients with mental health needs or dementia.

Updated 28 December 2016

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

• Staff knew how to recognise signs of abuse in 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.

• The practice could evidence the number of children who were on a child protection plan (this is a plan which identifies how health and social care professionals will help to keep a child safe).

• Patients who had a learning disability received an annual review of their health needs and a care plan was put in place. Carers of these patients were also encouraged to attend, were offered a health review and signposted to other services as needed.

• We saw there was information available on how patients could access various local support groups and voluntary organisations.