Archived: Lower Broughton Medical Practice 4

Updated 22 October 2015

Lower Broughton Medical Practice 4 has about 2,250 patients registered. It is overseen by NHS Salford Clinical Commissioning Group (CCG). The population experiences higher levels of income deprivation affecting children and older people than the practice average across England. There are a lower proportion of patients above 65 years of age (13.6%) than the practice average across England (16.7%). There are a high proportion of patients registered who are from a socially deprived background.

There are two partner GPs supported by a practice nurse. There is also a practice manager, and supporting administration and reception team.

The practice delivers commissioned services under the General Medical Services (GMS) contract.

The practice is open between 8.00am and 6.30pm Monday to Friday on a Saturday with extended hours available on Tuesdays until 8pm. Appointments are available daily from 9am to 11.30am and from 3.30pm to 5.30pm, and on Tuesdays from 6.30pm to 8pm.

Patients can book appointments in person or via the phone. Emergency appointments are available each day. Salford Royal NHS Foundation Trust provide urgent out of hours medical care when the practice is closed.

Updated 22 October 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Lower Broughton Medical Practice 4 on 22 September 2015. Overall the practice is rated as good.

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. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• 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 and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment and that there was continuity of care, with urgent appointments 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 practice proactively sought feedback from staff and patients, which it acted on.

We saw one area of outstanding practice:

• There is a weekly “welfare rights/citizen advice/debt advisory” clinic at the health centre for patients. This is well used and the health centre is one of the highest referrers into this service.

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

Importantly the provider should :

• Ensure that there is a record of all meetings that take place both internal and external to the practice and actions from these meetings are recorded.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 October 2015

The practice is rated as good for the care of people with long-term conditions. The GPs had lead roles in chronic disease management supported by the practice nursing staff 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 and a structured annual review to check that their health and medication needs were being met. 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 22 October 2015

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 A&E attendances. 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 and were recognised as individuals, and we saw evidence to confirm this. Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 22 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, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. All patients over the age of 65 who had more than one attendance at A&E within a 3 month period were identified and reviewed to assess their needs and prevent any further A&E attendances if possible.

Updated 22 October 2015

The practice is rated as good for the care of working-age people (including those recently retired). The needs of the working age population and those recently retired 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 provides appointments at a range of times, including later evenings to accommodate this population group.

Updated 22 October 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Patients experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia.

The practice had told patients experiencing poor mental health about how to access various health services, support groups and voluntary organisations. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

Updated 22 October 2015

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. It had carried out annual health checks for people with a learning disability and these patients had received a follow-up if necessary. The practice offered longer appointments for people with a learning disability.

The practice regularly 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. There is a weekly “welfare rights/citizen advice/debt advisory” clinic at the health centre for patients. This is well used and the health centre is one of the highest referrers into this service.

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.