Grenoside Surgery

Updated 23 March 2016

Grenoside Surgery is located in a purpose built health centre in Grenoside, Sheffield and has a branch site in Wadsley Bridge. It accepts patients from Grenoside, Wadsley Bridge and the surrounding area. The practice catchment area has been identified as one of the fourth most deprived areas nationally.

The practice provides General Medical Services (GMS) under a contract with NHS England for 7262 patients in the NHS Sheffield Clinical Commissioning Group (CCG) area. It also offers a range of enhanced services such as minor surgery and childhood vaccination and immunisations.

Grenoside Surgery has four GP partners (two female, two male), three salaried GPs (two female, one male), two female practice nurses, two female healthcare assistants, practice manager and an experienced team of reception and administration staff. The practice is a teaching practice for medical students.

The practice is open between 8am and 6.30pm Monday to Friday with the exception of Thursdays when the practice closes at 1pm. Extended hours are offered 6.30pm to 8.30pm Tuesday evenings and one Monday evening a month. Appointments are available with a GP between 8.45am and 11am and 3pm to 6.30pm daily (with the exception of Thursdays when the practice is closed and the GP collaborative provides cover). Other clinical appointments with the nurse and healthcare assistants are available throughout the day.

In addition to pre-bookable appointments that can be booked up to two weeks in advance for GPs and 12 weeks in advance for nurses and healthcare assistants, urgent appointments are also available for people that need them at the same day drop in clinic which is held at the main branch 8.45am to 10.15am daily. Patients could also request a same day telephone call back from the duty doctor if required for advice.

The branch site is open with consultations available between 8.30am and 12.15 daily. Urgent slots are available daily at the branch site or patients can access the drop in clinic at the main site.

When the practice is closed between 6.30pm and 8am patients are directed to contact the NHS 111 service. Patients are informed of this when they telephone the practice number.

The practice is registered to provide the following regulated activities; treatment of disease, disorder or injury, diagnostic and screening procedures, maternity and midwifery services, surgical procedures and family planning.

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. However, it was noted that a notification of the change had been received by CQC and the practice manager confirmed the practice was in the process of completing the application forms to add the new partner to the registration.

Updated 23 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Grenoside Surgery and the branch site at Wadsley Bridge on 23 February 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.
• Most risks to patients were assessed and well managed with the exception of some outstanding actions noted on the practice’s own infection prevention and control (IPC) audit. In addition, the branch site had not carried out a fire drill for some time.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had 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.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• 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 registered provider was aware of and complied with the requirements of the Duty of Candour.

We saw one area of outstanding practice:

• The practice staff gave examples where acts of care and kindness had been shown to patients. For example, one non clinical member of staff told us he had visited a patient at home following discharge from hospital and had assisted in re-setting the heating system to enable the patient to be more comfortable and reception staff told us they would book taxis for patients to go home following their appointment at the surgery should they request one.

The areas where the provider should make improvement are:

• Complete outstanding actions identified on own IPC audit. To include deep cleaning of carpets and fitting soap dispensers to walls in the treatment rooms.

• The practice should arrange for the branch site to undertake regular fire drills.

• The practice should ensure the system to check the expiry date of clinical consumables, for example, syringes is completed.

• The practice should maintain a record of completed daily cleaning schedules.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 23 March 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.

• Longer appointments and home visits were available for those who needed them.

• 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 23 March 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 or who were at risk, for example, children and young people who had a high number of A&E attendances. Childhood immunisation rates were comparable to national averages.

• 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.

• Data showed 96% of women eligible for a cervical screening test had received one in the previous five years compared to the national average of 81%.

• Appointments were available outside of school hours and the premises were suitable for children and babies. The practice operated a daily drop in clinic for any urgent appointments and a GP telephone advice system for patients to speak to the duty doctor.

• We saw positive examples of joint working with midwives and health visitors.

Updated 23 March 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 who needed them.

• The practice provided medical care and weekly routine GP visits to patients who resided in a local care home.

• The percentage of people aged 65 or over who received a seasonal flu vaccination was 74%, which was comparable to the national average of 73%.

Updated 23 March 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 evening appointments at the practice and weekend and evening appointments through the Sheffield satellite clinical scheme.

• The practice offered appointments at the practice with an adviser from a local charity who could offer employment and benefit advice or signpost to local support services.

• 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 23 March 2016

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

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

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

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

• Of those patients diagnosed with dementia, 76% had had their care reviewed in a face to face meeting in the last 12 months, which was slightly lower than the national average of 84%.

• Patients experiencing poor mental health had been advised 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.

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

Updated 23 March 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 homeless people and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with multidisciplinary teams in the case management of vulnerable people.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• Staff knew how to recognise signs of abuse in 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.