Hebden Bridge Group Practice

Updated 7 January 2016

Hebden Bridge Group Practice provides services to the Hebden Bridge, Mytholmroyd and Luddendenfoot areas of Hebden Bridge Hebden Bridge is a market town eight miles west of Halifax and Luddendenfoot is a small village four miles south east of Hebden Bridge. Mythalmroyd is a small village just over one mile east of Hebden Bridge. The practice has a patient list of 18864 patients, most of whom are white British. The practice is spread over three sites; Grange Dene Medical Centre in Mytholmroyd, Luddendenfoot Health Centre in Luddendenfoot and Valley Medical Centre in Hebden Bridge. The practice provides General Medical Services (GMS) under a locally agreed contract with NHS England. They offer a range of enhanced services such as childhood immunisations and extended opening hours access to appointments.

There are 12 GPs, eight of whom are female and four male. The practice is also staffed by two female nurse practitioners, six practice nurses five of whom are female and one male and two health care assistants (HCA) both female. The clinical team is supported by a Practice Business Manager, Patient Services Advisors (receptionists) and a team of administrative and secretarial staff. The practice is a training practice which means it supports the specialised training of qualified doctors wishing to become GPs.

The practice catchment area is classed as being within the group of the fourth least deprived areas in England. The age profile of the practice shows a higher percentage of the 40-69 year age group.

Grange Dene Medical Centre is open between 8am and 6.15pm. It has an earlier opening time of 7.15am on Wednesday and a later closing time of 7.15pm on Monday. Luddendenfoot Health Centre is open between 8am and 1pm Monday, Tuesday, Thursday and Friday and is closed Wednesdays. Valley Medical Centre is open between 8am and 6.15pm. It has an early opening time of 7.15am and Wednesday and Thursday. Several clinics run at Grange Dene Medical Centre and Valley Medical Centre each week, including antenatal, well baby clinic, ultrasound, healthy heart Clinic, asthma, diabetes and substance misuse.

Out of hours cover is provided by Local Care Direct and is accessed via the surgery telephone number or by calling the NHS 111 service.

Hebden Bridge Medical Centre is registered to provide treatment of disease, disorder or injury, surgical procedures, diagnostic and screening procedures, maternity and midwifery services and family planning from all three sites.

Updated 7 January 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hebden Bridge Group Practice on 24 November 2015. Overall the practice is rated as good.

Our key findings were:

• 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. At the time of our inspection an infection prevention and control audit had not been carried out but the practice made immediate plans to address this.
• 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 GP either face to face or by telephone consultation. Urgent appointments were 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 practic proactively sought and acted upon feedback from staff and patients.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw one area of outstanding practice:

• The practice had received a Gold Standard award for ‘Pride in Practice’ in recognition of their acknowledgement of the specific needs of their lesbian, gay, bisexual and transgender (LGBT) patients.

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

Importantly the provider should:

• Ensure an annual infection prevention and control (IPC) audit is carried out and any identified actions completed.
• Ensure that patient group directions (PGDs) which allow for the administration of vaccines by qualified nursing staff are in use and are updated regularly.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 January 2016

The practice is rated as good for the care of people with long term conditions.

• The practice had a nurse led approach to long term conditions, supported the the GPs.
• There were structured annual reviews in place to check the health and medication needs of patients were being met. The practice made use of the services of a pharmacist who was responsible for reviewing the medication needs of those patients taking 10 or more medicines.
• Longer appointments up to 30 minutes or longer, telephone consultations and home visits were available when needed.
• Staff worked with relevant health and social care professionals to deliver a multidisciplinary package of care. For example a weekly multidisciplinary meeting (MDT) was held with district nursing staff and palliative care nurses to review patients’ needs and inform future care planning.
• The percentage of patients on the diabetes register who had a recorded foot examination in the preceding 12 months was 85% which was comparable to other practices nationally.

Updated 7 January 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 who were looked after or were subject to a child protection plan. Immunisation rates were comparable with other practices for all standard childhood immunisations.

• Patients told us that children and young people were treated in an age-appropriate way and were treated as individuals. The waiting area had a designated child friendly space where parents and children could wait to be seen in a comfortable environment

• Appointments were available outside of school hours. Breast feeding and baby changing facilities were provided.

• Joint health visitor/GP baby clinics were held weekly at Grange Dene branch site and Valley Medical Centre.

• Data showed that 82% of eligible women had completed a cervical screening test in the preceding five years which was slightly higher than the CCG average and the same as the national average.

Updated 7 January 2016

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

• Nationally reported data showed that outcomes for patients were good for conditions normally associated with older people.

• All patients over 75 years of age were offered an annual holistic health check which included a medication review. The practice was responsive to the needs of older people, offering longer appointments and home visits if needed.

• The practice worked closely with other health care professionals such as the district nursing team and palliative care nurses to ensure housebound patients received the care they needed.

• The practice had links with two local residential homes for older people and feedback we received before the inspection indicated that both services were very happy with the standard of care the practice provided to their residents.

Updated 7 January 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 and flexible.

• The practice had extended hours, including pre-bookable late night appointments until 7.15pm at Grange Dene branch site and early morning appointments from 7am on Wednesday at Grange Dene branch site and on Wednesday and Thursday at Valley Medical Centre site.

• 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 for example minor surgical procedures and cervical screening services.

Updated 7 January 2016

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

• 94% of people with schizophrenia or other psychoses had a comprehensive agreed care plan documented in the last 12 months.

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

• Advance care planning was carried out for patients with dementia.

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

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

Updated 7 January 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 children subject to a child protection plan and those with a learning disability.
• Annual health checks were offered to those patients with a learning disability. Longer appointments were offered to this group of patients.
• The practice received input from the ‘Staying Well’ project which is designed to help combat loneliness and social isolation.
• The practice regularly worked with multidisciplinary teams in the case management of vulnerable people.
• The practice provided in-house support to those patients with substance misuse or alcohol problems as part of a shared care arrangement.
• The practice was participating in a local ‘Frailty Project’ which employed a multidisciplinary approach to identifying and caring for their most frail patients. This was still in the early stages of development and at the time of our visit the practice were not able to provide us with any data relating to outcomes for this project.
• 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.