Greenhead Family Doctors

Updated 21 March 2017

Greenhead Family Doctors, 15 Wentworth Street, Huddersfield, HD1 5PX, provides services for 2,879 patients. The provider is situated within the Greater Huddersfield Clinical Commissioning Group and delivers primary medical services under the terms of a general medical services (GMS) contract.

Services are provided within a converted Victorian terraced building which is owned and maintained by the partners. The building has been adapted to provide ground floor level access for those with mobility difficulties and consulting rooms are available on the ground floor when required. Disabled patients with complex needs are also visited at home as required.

The population experiences higher than average levels of deprivation and is mainly White British. Greenhead Family Doctors is registered as a partnership between Dr Ramesh Edara and Dr Madhuri Navaluri. Dr Edara works full time and Dr Madhuri works slightly less; undertaking six clinical sessions per week.The practice also has two part time female practice nurses equivalent to 0.5 W.T.E, and a health care assistant who works 31 hours a week.

The practice manager is supported by her assistant and 5 part time reception and administrative staff.

The practice at Greenhead Family Doctors is open Monday to Friday with telephone services from 8am to 6pm and access to the surgery from 8.15am to 6pm.

Surgeries run from 9.10am to 11.10pm and from 3pm to 5pm. A women’s’ clinic runs on Friday 12.30pm to 2.30pm and an extended hours clinic is offered on Monday and Tuesday 6.30pm to 7.30pm for pre-booked appointments. When the surgery is closed patients are advised of the NHS 111 service for non –urgent medical advice and are directed to a local out of hours provider, Local Care Direct.

Updated 21 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Greenhead Family Doctors on 10 February 2017. 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.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• 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.
• 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.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day. However, some patients told us that it was sometimes more difficult to book a routine appointment in advance.
• The practice had good facilities and was well equipped, despite the limitations of the Victorian building, to treat patients and meet their needs. We saw that patients with mobility issues who found accessing the surgery difficult were visited at home or had their consultations arranged on the ground floor.
• There was a clear and visible leadership structure and staff felt supported by 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 areas where the provider should make improvement are:

• Undertake a review of the approach to complaints resolution to assure themselves that patients are advised in writing that the practice has concluded their response and that further representations can be made to the Parliamentary and Health Service Ombudsman.

• Arrange appropriate awareness training on the Mental Capacity Act for relevant staff across the team who have yet to receive it.

• Continue to review the most appropriate arrangements for the secure storage of cleaning products.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 21 March 2017

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.

• 66% of diabetic patients on the register had achieved a blood sugar result of 59 mmol or less in the preceding 12 months. This demonstrated that their diabetes was being well controlled. This was 5% lower than the local average and 4% lower than the national average. In addition, 73% of diabetic patients had received a foot examination to check for nerve or skin damage associated with their condition. This was 13% lower than both the local and national average. The provider had recently recruited a practice nurse with specialised skills in diabetes and was engaged in a programme of review to improve care for this patient group.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and were offered 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 21 March 2017

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 in line with or higher than local and 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.

• The practice’s uptake for the cervical screening programme was 85%, which was the same as the CCG average of 85% and higher than the national average of 81%.

• A full range of contraceptive services including implants and coils was provided by a female GP at the practice.

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

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

Updated 21 March 2017

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.

• A nursing home visit protocol had been developed to assist in identifying appropriate support to these patients.

• The practice maintained good links with local care homes and the multi-disciplinary care home support team.

Updated 21 March 2017

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. Telephone appointments and evening appointments were available.

• The practice was proactive in offering online services such as appointment booking and medication requests as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 21 March 2017

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

• 84% of eligible patients diagnosed with dementia  had had their care reviewed in a face to face meeting in the last 12 months, which was  1% higher than the national average

• 86% of patients experiencing a serious mental illness had an up to date care plan. This was 8% higher than the national average.

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

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

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

• Patients with mental health issues were actively supported with same day appointments for patients in need.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

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

Updated 21 March 2017

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 a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed 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.