Wellington House

Updated 10 February 2017

Drs. Lawson, Scales, Tarrant & Napper provide primary care medical services to 8,985 patients in North Kirklees under a General Medical Services (GMS) contract. The area is in the fourth decile on the scale of deprivation.

The practice, known locally as Wellington House Surgery is located at Wellington House, 4 Henrietta Street, Batley, West Yorkshire, WF17 5DN, close to local shops and transport links. There is a branch surgery at 4 Bond Street, Birstall, WF17 9EX. Patients can attend either location.

In addition to primary care services, the practice hosts midwifery clinics.

There are five GPs, four male and one female; two female practice nurses, one female healthcare assistant, a pharmacist and a team of administrative staff. At the time of the inspection the practice had 1.5 whole time equivalent vacancies for GPs and were actively trying to recruit to these posts.

The practice gained training practice status in November 2015. They are able to accommodate GP registrars and nursing students on placement.

The main surgery is open between 8am and 6pm Monday to Friday and Saturday mornings from 8am to 12.30pm. Between 6pm and 6.30pm the practice have an arrangement with Local Care Direct. Telephone calls are transferred to the service who assess incoming calls

and refer on to the duty doctor.

Appointments at Wellington House are from 8am to 6pm daily. The branch surgery at Birstall is open daily between 8am to 12 noon and 2pm to 6pm except Wednesdays when it is closed in the afternoon.

Extended hours appointments are offered on Saturday mornings from 8am to 12.30pm.

When the practice is closed, telephone calls are transferred to the out of hours service provider Local Care Direct, or patients can call NHS 111 directly.

Updated 10 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Drs. Lawson, Scales, Tarrant & Napper on 18 May 2016. Overall the practice was rated as good. However, breaches of the legal requirements were found leading to a rating of requires improvement in the key question of Safe. After the inspection the practice wrote to us to say what they would do to meet the legal requirements in relation to the safety of the practice.

We undertook a focussed follow up inspection at Drs. Lawson, Scales, Tarrant & Napper on 17 January 2017 to check that the practice had met the requirements. This report only covers our findings in relation to those requirements. Overall the practice is now rated as good for providing safe services.

You can read the full comprehensive report which followed the inspection in May 2016 by selecting the 'all reports' link for Drs. Lawson, Scales, Tarrant & Napper on our website at www.cqc.org.uk.

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

• The practice had addressed the issues identified during the previous inspection.
• Risks to patients were assessed and well managed.
• Vaccines were stored and managed appropriately in line with Public Health England guidance.
• The practice had a number of policies and procedures to govern activity, and we saw that these had been reviewed.
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. All incidents and significant events had been reported and investigated. For example, following a vaccine fridge failure in 2015 practice procedures were now appropriately followed. For example, a power cut to the practice the week before the reinspection was clearly documented and actions were appropriately followed.
• The practice had developed systems to monitor expiry dates for emergency medicines and other equipment, for example spillage kits.
• The practice improved the complaints procedure by including details of the Parliamentary Health Service Ombudsman in patient information.
• The practice ensured clinical waste bags were labelled in line with current legislation and guidance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 July 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.
• The practice used templates on the clinical system to ensure patient consultations and reviews were carried out in line with NICE guidance.
• Performance for diabetes related indicators were similar to the national average. For example, 98% of patients with diabetes, on the register, had a record of a foot examination and risk classification in the previous year (CCG average 89%, national average 88%).
• Longer appointments and home visits were available when needed.
• Patients were provided with care plans and appropriate advice to help them manage their conditions.
• GPs and nurses used e-consultations with hospital diabetes and cardiology specialists to plan care for patients.
• Patients with complex needs at high risk of hospital admission who were not under the care of a community matron were referred to a CCG employed Care Co-ordinator who visited them regularly and supported them to manage their condition.
• 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 22 July 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 and young people who had a high number of accident and emergency (A&E) attendances.
• Immunisations were undertaken by the community health visiting team. Uptake rates were relatively high for all standard childhood immunisations.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals.
• The practice’s uptake for the cervical screening programme was 84%, which was better than the CCG and national averages of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• Minutes of joint meetings and care documentation showed that the practice worked closely with other local health and social care services, including midwives, health visitors, school nurses and care co-ordinators.
• The practice hosted antenatal and midwifery clinics.
• The GPs carried out postnatal and six week baby checks.

Updated 10 February 2017

Updated 22 July 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.
• Extended hours pre bookable appointments were offered on Saturday mornings from 8am to 12.30pm
• 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.
• Telephone consultations were offered for working patients who were unable to attend the practice.
• The practice used text messages to remind patients of appointments.

Updated 22 July 2016

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

• 70% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is lower than the national average of 84%. The practice had a development plan to improve performance in this area.
• 82% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive care plan documented in the record, in the preceding 12 months.
• 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.
• 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.

Updated 22 July 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, travellers and 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.
• The practice regularly reviewed vulnerable patients with health visitors and local safeguarding teams.
• The practice’s computer system alerted GPs if a patient was also a carer. Carers were offered seasonal flu vaccinations and written information was available to direct carers to local support services.
• The practice hosted a shared care drug dependency scheme. At the time of the inspection eleven patients were receiving treatment and support for opiate dependency.