Archived: Gorton Street Practice

Updated 28 July 2016

Gorton Street Practice is situated in central Blackpool within the Sure Start Children’s Centre, a building owned by the local Blackpool council. The building is a purpose built two-storey building. All patient areas are situated on the ground floor of the practice except for one room upstairs for patient counselling services.

There is limited onsite parking for patients but street parking is available and the practice is close to public transport. The practice provides services to 3890 patients.

The practice is part of the NHS Blackpool Clinical Commissioning Group (CCG) and services are provided under an Alternative Provider Medical Services Contract (APMS) (this contract allows for services to be provided by outside organisations). At Gorton Street Practice, the practice GP services are provided by a GP partnership at a neighbouring practice.

There is one male GP partner, one male salaried GP and one male regular locum GP. The practice is a training practice for medical students and GP trainees at different stages of their learning. At the time of inspection, there was one male GP registrar working at the practice. At times of GP absence from the practice there are an additional two GP partners, one male and one female, who can provide GP services. The practice also employs two practice nurses, a health care assistant, one phlebotomist who also works as an administrator and one clinical pharmacist. Non-clinical staff consist of a practice manager and six administrative and reception staff who support the practice.

The practice is open between 8am and 8pm on Monday and Tuesday and between 8am and 6.30pm on Wednesday to Friday. Extended opening hours are offered on Saturday mornings between 9am and 12 noon. When the practice is closed, patients are able to access out of hours services offered locally by the provider Fylde Coast Medical Services by telephoning 111.

The practice has a significantly larger proportion of patients aged under four years of age (11%) compared to the national average (6%) and more patients (30%) aged less than 18 years of age compared to the national average of 17%. There are also significantly fewer patients aged over 60 years of age (9%) compared to the national average of 22%.

Information published by Public Health England rates the level of deprivation within the practice population group as one on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

The practice caters for a larger proportion of patients experiencing a long-standing health condition (68% compared to the local average of 63% and national average of 54%). The proportion of patients who are in paid work or full time education is lower (33%) than the CCG average of 52% and lower than the national average of 62% and unemployment figures are significantly higher, 30% compared to the CCG average of 7% and the national average of 5%.

The practice provides level access for patients to the building with automated entry doors and is adapted to assist people with mobility problems.

Updated 28 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Gorton Street Practice on 22 June 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.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients 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 provider was aware of and complied with the requirements of the duty of candour.

We saw two areas of outstanding practice:

• In response to the needs of the local population, the practice offered a sexual health clinic to all patients in the area both registered at the practice or elsewhere. They offered all patients free HIV screening.
• The practice had a higher percentage of lesbian, gay, bisexual and transgender (LGBT) patients (7%) on its list compared to the national average (1.5%). The practice had been recognised as being LGBT friendly by the local LGBT group and had been awarded the Navajo mark.

The areas where the provider should make improvement are:

• Ensure that systems are put in place to check that actions identified by significant event reports are put in place and are effective.
• Ensure that all items of communication received by the practice are seen by the GPs before being filed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 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.
• Performance for diabetes related indicators was comparable to the local clinical commissioning group (CCG) and national averages. For example, blood measurements for diabetic patients showed that 83% of patients had well controlled blood sugar levels compared with the CCG average of 83% and national average of 78%.
• Longer appointments and home visits were available when needed.
• 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 28 July 2016

The practice is rated as outstanding 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. The practice had a register of all looked after children and a high awareness of its safeguarding responsibilities.
• Immunisation rates were 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.

• The practice offered a referral to all teenage pregnancy mothers to a family nurse practitioner to support them through their pregnancy and with the new baby. The practice showed us figures relating to 2009 to 2016 that indicated a reduction in the rate of teenage patients having babies.
• The practice offered condoms free in the practice.
• In response to a staff suggestion, the practice sent a new baby letter to all new mothers which offered congratulations and gave advice and information on patient support services.
• Patients could access social care advice clinics in the practice premises and smoking cessation advice was available from the practice pharmacist or by referral to a local support group.

• Appointments were available outside of school hours and the premises were suitable for children and babies.
• Same day appointments were available for children and the practice ensured that these were always available by specifically allocating them on the practice computer system.
• In response to the needs of the local population, the practice offered a sexual health clinic to all patients in the area both registered at the practice or elsewhere. They offered all patients free HIV screening.
• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 28 July 2016

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

• The practice offered proactive, personalised care to meet the needs of the older people in its population.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice dealt with home visit requests in a prompt and safe manner.
• The practice offered a named GP for all patients aged over 75 years of age. Patients told us that they could get an appointment easily with the GP of their choice for a routine matter.

Updated 28 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.
• The practice offered late opening until 8pm on Monday and Tuesday as well as Saturday morning.
• 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 28 July 2016

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

• 100% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was better than the national average of 84%.
• 92% of people experiencing poor mental health had a comprehensive, agreed care plan documented in the record compared to the national average of 88%.
• 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. They supported a new service for patients that offered timely therapy for people feeling depressed or anxious. We saw evidence that by signposting patients to this new service, the practice had reduced their patient referrals to mental health services.
• 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.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 28 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. They had a good awareness of useful services for homeless patients and referred patients to these when appropriate.
• The practice offered longer appointments for patients with a learning disability.
• One of the practice staff had some knowledge of basic sign language.
• 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 had a higher percentage of lesbian, gay, bisexual and transgender (LGBT) patients (7%) on its list compared to the national average (1.5%). The practice had been recognised as being LGBT friendly by the local LGBT group and had been awarded the Navajo mark.