Archived: Hilton Road Surgery

Updated 1 October 2015

Hilton Road Surgery is situated within a converted end terraced house in Leeds.

The practice provides Alternative Provider Medical Services (APMS) for 2000 patients under a contract with NHS Leeds North Clinical Commissioning Group (CCG).

There are five salaried GPs, four male and one female. The clinical team also includes an advanced nurse practitioner, a practice nurse and a health care assistant. An experienced team of management, administrative and reception staff support the practice. This practice is part of One Medicare Ltd who operates a number of practices across the country.

The practice opening times are Monday to Friday 8am to 6pm with extended hours on a Thursday until 7pm. Drop in clinics are available Monday, Tuesday, Thursday and Friday from 9.20am to 11.40am.

Local Care Direct provides services between 6 pm and 6.30 pm. Calls to the practice are automatically redirected to this service. Between 6.30 pm and 8 am out of hours services are also provided by Local Care Direct and are accessible by calling the NHS 111 service.

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

Updated 1 October 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hilton Road Surgery on 21 July 2015. Overall the practice is rated as requires improvement.

Specifically, we found the practice to be good for providing well-led, caring and responsive services. However it was rated as requires improvement for safe and effective services. It was rated as good for providing services for all population groups other than for the care of people whose circumstances may make them vulnerable where they are rated as requires improvement.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Most information about safety was recorded, monitored, appropriately reviewed and addressed.
• The majority of patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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 was available and easy to understand.
• Patients said they found the appointment system very accessible.
• The practice had adequate facilities and was 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.

There were areas of outstanding practice.

• We found there was outstanding practice to support women, where English was not their first language, to access cervical screening and improve cervical screening uptake. Cervical screening rates at the practice were 85% slightly above the national average of 81.88%. The practice had also developed a health champion role and weekly drop-in clinics had been implemented for women to discuss health topics such as cervical screening. (Practice Health Champions are people who voluntarily give their time to work with the staff in their local GP Practice or surgery to find new ways to improve the services that the practice offered and to help to meet the health needs of patients and the wider community).

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

• It was not clear if information from external sources such as National Patient Safety Agency (NPSA) was disseminated to relevant staff and that appropriate action had been taken.
• Patients at risk were not routinely highlighted on the electronic patient record system.
• Records did not show if clinical staff had undertaken recommended level three training in safeguarding children.
• Staff registration with the appropriate professional body was checked upon employment but was not checked on an annual basis to ensure that registration had not lapsed.
• There was a lack of evidence that the prevalence of some diseases had been assessed in order to show they were identifying all patients with long term conditions.
• The practice had not carried out annual health checks for people with a learning disability.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 1 October 2015

The practice is rated as requires improvement for the care of people with long-term conditions. There was a lack of evidence that the prevalence of some diseases had been assessed in order to show they were identifying all patient’s with long term conditions. Reviews to check health and medication needs were available but patient’s had to attend for multiple appointments if they had multiple conditions. The practice was working to improve this and processes were in place to implement changes.

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 when needed. All these patients had a named GP. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 1 October 2015

The practice is rated as good for the care of families, children and young people. Children at risk were not routinely highlighted on the electronic patient record system.

Immunisation rates were relatively high for all standard childhood immunisations. Patients told us that children and young people were treated in an age-appropriate way. Appointments were available outside of school hours.

We found there was outstanding practice to support women where English was not their first language to access cervical screening and improve cervical screening uptake and cervical screening rates were higher than the national average. The practice had also developed a health champion role and weekly drop-in clinics had been implemented for women to discuss health topics such as cervical screening. (Practice Health Champions are people who voluntarily give their time to work with the staff in their local GP Practice or surgery to find new ways to improve the services that the practice offered and to help to meet the health needs of patients and the wider community).

Updated 1 October 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services. It was responsive to the needs of older people and offered home visits and longer appointments where required.

Updated 1 October 2015

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 was proactive in offering online services as well as a range of health promotion and screening that reflects the needs for this age group.

Updated 1 October 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice had told patients experiencing poor mental health how to access various support groups and voluntary organisations. The practice had a range of enhanced services including dementia and used a dementia tool as part of the dementia identification scheme. Longer appointments were available for this group of patient’s.

Updated 1 October 2015

The practice is rated as requires improvement for the care of people whose circumstances may make them vulnerable. The practice did not hold a register of patients living in vulnerable circumstances including children and those with a learning disability. It had not carried out annual health checks for people with a learning disability.

The practice worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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. Longer appointments were offered for people where required.