Background to this inspection
Updated
30 March 2016
Dr C T Heatley and Partners also known as Birley Health Centre is located in a purpose built health centre in Birley and accepts patients from the surrounding area. The practice catchment area has been identified as one of the fifth most deprived areas nationally.
The practice provides Primary Medical Services (PMS) under a contract with NHS England for 8257 patients in the NHS Sheffield Clinical Commissioning Group (CCG) area. It also offers a range of enhanced services such as minor surgery, anticoagulation monitoring and childhood vaccination and immunisations.
Dr C T Heatley and Partners has five GP partners (two female, three male), two female salaried GPs, two female nurse practitioners, two female practice nurses, four female healthcare assistants, practice manager partner and an experienced team of reception and administration staff. The practice is a teaching and training practice for medical students and nurse students.
The practice is open 8am to 6pm Monday to Friday with the exception of Tuesdays when the practice closes at 12.30noon and Thursday and Friday when the practice opens at 8.30am. Extended hours are offered 6.30pm to 8pm Monday evenings and 7.30am to 8am alternateTuesday mornings. Morning and afternoon appointments are offered every day with the exception of Tuesday afternoon when the practice is closed.
When the practice is closed between 6.30pm and 8am patients are directed to contact the NHS 111 service. The Sheffield GP Collaborative provides cover when the practice is closed between 8am and 6.30pm. 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. The practice manager partner told us this would be reviewed immediately.
Updated
30 March 2016
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Dr C T Heatley and Partners (known as Birley Health Centre) on 16 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 . However, the practice had not completed a risk assessment for legionella (Legionella is a term for a particular bacterium which can contaminate water systems in buildings).
- 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 told us 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 were able to make a same day appointment to see a GP or nurse practitioner if their problem was urgent.
- 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 provided a door to door bus service in joint conjunction with the local authority two days a week for patients who were too frail, elderly or unable to access the practice independently as there was no public bus service in the area.
The areas where the provider should make improvement are:
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Maintain a complete record of the immunity status of all clinical staff.
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The practice should complete the monitoring and recording cycle documenting the movement of blank prescriptions within the practice.
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Complete a risk assessment for legionella.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
30 March 2016
The practice is rated as good for the care of people with long-term conditions.
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Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
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Longer appointments and home visits were available when needed.
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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.
Families, children and young people
Updated
30 March 2016
The practice is rated as good for the care of families, children and young people.
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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. Immunisation rates were higher than national averages.
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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.
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Data showed 87% of women eligible for a cervical screening test had received one in the previous five years compared to the national average of 81%.
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All children under the age of two were offered a same day appointment. Appointments were available outside of school hours and the premises were suitable for children and babies.
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The GPs would routinely visit women at home who had given birth to assess their health and wellbeing needs.
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We saw positive examples of joint working with midwives and health visitors.
Updated
30 March 2016
The practice is rated as good for the care of older people.
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The practice offered proactive, personalised care to meet the needs of the older people in its population.
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The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those who needed them.
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The practice provided, in conjunction with the local authority, a bus service two days a week for patients who were too frail, elderly or unable to get to the practice by themselves as there was no public bus service in the area.
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The practice provided medical care and weekly routine GP visits to patients who resided in two local care homes.
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The practice had a system in place where the receptionist would telephone every patient aged over 75 who had been discharged from hospital to ensure their ongoing needs were met. The practice also referred patients to the community support worker who could offer advice and support on social care and wellbeing issues.
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The percentage of people aged 65 or over who received a seasonal flu vaccination was 77%, higher than the national average of 73%.
Working age people (including those recently retired and students)
Updated
30 March 2016
The practice is rated as good for the care of working-age people (including those recently retired and students).
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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.
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The practice offered evening and early morning appointments at the practice and weekend and evening appointments through the Sheffield satellite clinic scheme. The practice also offered GP e-consultations for patients who required advice and could not attend the practice.
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The practice offered appointments at the practice with an occupational health adviser and was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs of this age group.
People experiencing poor mental health (including people with dementia)
Updated
30 March 2016
The practice is rated as good for the care of people experiencing poor mental health (including people living with dementia).
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Of those patients diagnosed with dementia, 81% had had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average of 84%.
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Of those patients diagnosed with a mental health condition, 100% had a comprehensive care plan reviewed in the last 12 months, which is above the national average of 88%.
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The practice regularly worked with multidisciplinary teams in the case management of people experiencing poor mental health, including those living with dementia.
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The practice carried out advance care planning for patients with dementia.
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Patients experiencing poor mental health were advised how to access various support groups and voluntary organisations.
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Staff had a good understanding of how to support patients with mental health needs and dementia.
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The practice hosted Improving Access to Psychological Therapies Programme (IAPT) to support patients’ needs.
People whose circumstances may make them vulnerable
Updated
30 March 2016
The practice is rated as good for the care of people whose circumstances may make them vulnerable.
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The practice held a register of patients living in vulnerable circumstances including homeless people and those with a learning disability.
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The practice offered longer appointments for patients with a learning disability.
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The practice regularly worked with multidisciplinary teams in the case management of vulnerable people.
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The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
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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.