Northern Moor Medical Practice

Updated 25 October 2016

Northern Moor Medical Practice is a long-established GP surgery, situated opposite Wythenshawe Park in South Manchester. There is a small car park in front of the surgery, but cars can also park on the street nearby. The practice provides services to 3169 registered patients.

The demographic area served by the practice contains a higher proportion of young people (8.4% aged 0-4, compared to the national average of 5.9%, 13.3% aged between 5-14 years, compared to the national average of 11.4% and 24.8% aged under 18, compared to the national average of 20.7%). The practice serves a lower proportion of over 65 year olds, 10.2% compared to the national average of 17.1%.

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

The practice patient population with health-related problems in daily life, is 55%, comparable to the national average of 54%. The proportion of patients who are in paid work or full time education 62.7% is also comparable to the national average of 61.5%.

The practice is part of the NHS South Manchester Clinical Commissioning Group (CCG) and services are provided under a General Medical Services contract (GMS). There are three GP partners (two male and one female), as well as two female salaried GPs. The practice also employs a female practice nurse. Non-clinical staff consisted of a practice manager and five administrative/reception staff. All staff including GPs are part time.

Northern Moor Medical Practice is a training practice for GP registrars and medical students.

The practice is open between 8am and 6pm Monday to Friday. Extended hours surgeries are offered between 6:30pm and 7pm on a Monday evening and between 7:30am and 8am on a Tuesday morning with availability with both the GP and practice nurse.

When the practice is closed, patients are able to access booked appointments with the GP federation (of which the practice is a member) from 6pm -8pm every weekday and 9.30am to 1.30pm Saturday and 10am – 12pm Sunday as well as out of hours services offered locally by the provider Go To Doc for more urgent matters.

Updated 25 October 2016

Letter from the Chief Inspector of General Practice

We had previously carried out an announced comprehensive inspection of Northern Moor Medical Practice in December 2015 when breaches of the Health and Social Care Act 2014 were found.

Overall at the inspection in December 2015 we rated the practice as requires improvement. After the inspection, the practice submitted an action plan detailing the action they intended to take to address the identified breaches of regulations.

We undertook this inspection at Northern Moor Medical Practice on 12 September 2016 to review the action taken.

Overall, the practice is now 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 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.

• Feedback from patients about their care was consistently positive.

We saw one area of outstanding practice:

The practice nurse had attended training with an external organisation that raised awareness of Forced Marriage and Honour Based Abuse and supported victims and survivors. This training provided knowledge and skills and was used to appropriately respond to requests from patients for help in relation to forced marriage and honour based abuse. Staff also had access to information about female genital mutilation (FGM) and various support groups patients at risk could be referred to.

The areas where the provider should make improvements are:

• Sharps bins should be dated when they are set up for use.

• A copy of the safeguarding flow chart should be displayed in all consulting rooms.

• Signage should be displayed on rooms where oxygen cylinders are stored

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 October 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.

• Patients with diabetes, on the register, in whom the last IFCC-HbA1c was 64 mmol or less in the preceding 12 months was 93%. This was above the CCG and national average of 76.82% and 77.54% respectively.

• The percentage of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months was 95%, which was above the CCG and national average of 87.35% and 88.3% respectively.

• 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 25 October 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 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.

• 91% of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding 5 years. This was above the CCG and national average of 82.8% and 82% respectively.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

• The practice nurse had attended training with an external organisation that raised awareness of Forced Marriage and Honour Based Abuse and supported victims and survivors. This training provided knowledge and skills and was used to appropriately respond to requests from patients for help in relation to forced marriage and honour based abuse

Updated 25 October 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.

We saw evidence of formal minutes for meetings, such as practice, multidisciplinary, palliative care and safeguarding, where the needs of older people were formally discussed

Updated 25 October 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 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 25 October 2016

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

• 90.57% of patients with schizophrenia, bipolar affective disorder and other psychoses  had a comprehensive, agreed care plan documented in the record, in the preceding 12 months, was above  the CCG and national average of 86.76% and 88.47% respectively.

• 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.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 25 October 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, asylum seekers 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 nurse had attended training with an external organisation that raised awareness of Forced Marriage and Honour Based Abuse and supported victims and survivors. This training provided knowledge and skills and was used to appropriately respond to requests from patients for help in relation to forced marriage and honour based abuse