Archived: BL Medical Practice

Updated 24 April 2017

BL Medical Practice, 1st Floor, Woodley Health Centre, Hyde Road, Woodley, Stockport is part of the NHS Stockport Clinical Commissioning Group (CCG). Services are provided under a general medical service (GMS) contract with NHS England. The practice has approximately 2200 patients on their register.

The practice building is a modern building maintained by NHS Property Services. The practice is located on the first floor. There are also three other GP practices located on the first floor. Patients can access the first floor via the passenger lift. A hearing loop to assist people with hearing impairment is available. Limited car parking is available at the practice, but additional parking is available close by.

The practice is a registered partnership between one male and one female GP. The practice employs a practice manager, a practice nurse, a senior receptionist, and reception/ administration staff.

The practice reception is open from 9am until 6.30pm Monday, Tuesday and Friday; 9am until 5pm on Wednesday and 9am until 7.30pm on Thursdays. GP consultation times are offered Monday to Friday from 9am until 10.30am, Tuesday and Friday afternoons 4pm until 5pm and Monday and Thursday evenings 5pm until 6.30pm. Later evening GP and practice nurse appointments are available until 7.30pm on Thursdays.

When the practice is closed patients are asked to contact NHS 111 for Out of Hours GP care.

The practice provides online access that allows patients to book appointments and order prescriptions.

Information published by Public Health England rates the level of deprivation within the practice population group as 5 on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. The average male life expectancy in the practice geographical area is 79 years and is reflective of both the England and CCG averages. Female life expectancy is 82 years which is below the CCG and England average of 83 years.

Updated 24 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at BL Medical Practice on 4 April 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 a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety. Areas for review included developing an incident protocol and reviewing arrangements around monitoring uncollected prescriptions and monitoring of prescription paper.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment. One patient had participated in the interview process when the practice was recruiting a GP partner.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with 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.
• 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 practice had a patient reference group (PRG). Feedback from members of the PRG indicated that communication between the practice and the group was infrequent.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

We saw one area of outstanding practice:

• The GP partners were described as going the extra mile and patients with serious health issues provided examples of where a GP contacted them every week to review their health and wellbeing.

The areas where the provider should make improvement are:

• Develop practice incident recording procedures to include non significant events.
• Further develop the records to monitor the use of prescription paper in line with the NHS Security of prescription forms guidance.
• Provide opportunities for members of the patient reference group to become more actively involved in the development of the practice by improving communication and explore opportunities for patients to contribute who do not have access to IT.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 April 2017

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

• The practice nurse had a lead role in long-term disease management and patients at risk of hospital admission were identified as a priority.
• The practice achieved higher percentages for the diabetes, and chronic obstructive pulmonary disease (COPD) indicators outlined in the Quality and Outcomes Framework (QOF) for 2015/16 when compared to local and national averages.
• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.
• There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health.
• All these patients had a named GP and there was a system to recall patients for 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 24 April 2017

The practice is rated as good for the care of families, children and young people.

• From the sample of documented examples we reviewed we found there were systems 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.
• Data from 2016/16 indicated that immunisation rates were below the local average for all standard childhood immunisations. However evidence supplied by the practice showed the practice was achieving almost 100% immunisation rates since April 2016.
• Quality and Outcome Framework (QOF) 2015/16 data showed that 82% of patients with asthma on the register had an asthma review in the preceding 12 months compared to the local and England average of 75%.
• The practice’s uptake for the cervical screening programme at 85%, was higher than the local and the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice worked with midwives, health visitors and school nurses to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.
• The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications.

Updated 24 April 2017

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

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.
• The practice offered proactive, personalised care to meet the needs of the older patients in its population.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.
• Planned weekly telephone calls to two local care homes were undertaken by the GPs to monitor their patients’ health and wellbeing. This provided continuity of care.
• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.
• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible. For example the practice had a staff member designated as a cancer champion. The focus of the cancer champion was to encourage older patients to undertake the bowel screening test.

Updated 24 April 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these populations 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 offered flexible surgery times including, morning, afternoon and evening surgeries. Later evening appointments were available until 7.30pm on Thursdays. In addition patients could book appointments with the local seven day primary care service.
• 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.

Updated 24 April 2017

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

• Patients at risk of dementia were identified and offered an assessment.
• 100% of patients diagnosed with dementia had their care reviewed in a face to face meeting within the last 12 months.
• The practice carried out advance care planning for patients living with dementia. Care plans were reviewed every six months with the support of a community psychiatric nurse (CPN).
• The practice specifically considered the physical health needs of patients with poor mental health and dementia.
• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.
• 100% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan recorded in the preceding 12 months, which was higher than the local and national average.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.
• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

Updated 24 April 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 homeless people and those with a learning disability.
• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.
• 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 had information available for vulnerable patients about how to access various support groups and voluntary organisations.
• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.