Cumberland House Surgery

Updated 8 September 2016

Cumberland House Surgery is located in Waters Green Medical Centre, Sunderland Street, Macclesfield, Cheshire. The large modern medical centre is near to the centre of the town. The building was planned and built by six GP practices and patients can also access many other clinics and services. There is easy access to the building and disabled facilities are provided. There is a large underground car park serving all of the medical facilities on the site.

There are thirteen GPs working at the practice. Seven GPs are partners, three male and four female and six GPs are salaried, three male and three female. There is a total of 8.35 whole time equivalent GPs available. There are six nurses, three full time and three part time (one of these is a nurse practitioner), all female, one full time female health care assistant and a practice pharmacist. There is a full time practice manager, a records manager, an assistant practice manager and a team of administrative staff..

The practice opening times are 8am until 6.30pm Monday to Friday. Appointments are available 8.30am to 11.30am and 3.30pm to 5.50pm each day. There are also extended opening hours from 7.30am to 8am and 6.30pm to 8pm each day.

Patients requiring a GP outside of normal working hours are advised to call the 111 service who will transfer them to Macclesfield Out of Hours Services.There are 15,271 patients on the practice list. The majority of patients are white British with a high number of elderly patients and patients with chronic disease prevalence. On the Index of Multiple Deprivation the practice is slightly below the England average with lower than average levels of deprivation affecting children and older people. The practice holds a PMS contract with NHS England (Cheshire & Merseyside). It forms part of Eastern Cheshire Clinical Commissioning Group which consists of 23 GP Practices.

This practice has been accredited as a GP training practice and has qualified doctors attached to it training to specialise in general practice and also offers placements to medical students and pharmacists.

Updated 8 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Hodgson JM & partners (also known as Cumberland House Surgery) on 5th May 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 the services provided 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 several areas of outstanding practice:

• An annual senior citizens event was held in conjunction with other agencies to offer health checks and advice to patients.

• The practice had established a “Young Persons hub” in the waiting area where teenage patients could access information using the internet to guide them in their choices about treatment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 8 September 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 better than the national average.

• 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.

• The practice provided blood pressure machines for home monitoring of blood pressure levels and had introduced FLO tele-monitoring of blood pressure.

• An investigations suite was currently being planned in conjunction with other practices within the building to offer 24 Hour BP checks and ECG spirometry.

• Extended care planning was being developed for patients with Parkinson’s disease and Multiple sclerosis.

• A smoking cessation service was available within the health centre.

Updated 8 September 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. These were provided both at immunisation clinics, by appointment or via drop in.

• 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.

• 81% of women aged 25-64 are recorded as having had a cervical screening test in the preceding 5 years. This compared to a CCG average of 83% and a national average of 82%.

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

• There was a ‘Young Persons’ hub’ in the waiting room which provided information appropriate to that age group.

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

• The practice used separate 0-14years new patient questionnaires which included school and nursery information.

• A texting service was used to encourage teenagers to engage with stopping smoking and asthma clinic attendance.

• The practice offered access to a comprehensive family planning services including coil fitting.

Updated 8 September 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 ran an annual senior citizens event which included a flu clinic, health promotion advice, BP monitoring, advice from the Fire service about smoke alarms, Age UK attended to offer advice as did the red button alarm service, East Cheshire hospice and Macclesfield Borough Council .The local newspaper promoted the event before and after to signpost patients to the services available.
• Practice staff visited care homes over three days each week to provide ward rounds, confer with staff and managers and provide advice on medicine management.
• The care planning process was currently being extended to a further 3% of the practice population (beyond the 2% involved in the Proactive care program.)
• Staff referred patients to a primary care team based in the same building including District Nurses and Community matrons so that patients could receive a seamless service to meet their needs.

Updated 8 September 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 including electronic prescriptions as well as a full range of health promotion and screening that reflects the needs for this age group. Direct E mail access was also offered by the administrative team.

• The practice offered open access to physiotherapy and exercise on prescription

Updated 8 September 2016

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

• 94% 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. This compared to a CCG average of 93% and a national average of 88%.

• 92% of patients with mental health conditions had their smoking status recorded in the preceding 12 months. This compared to a national average of 93%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia and provided personalised medicine management including daily prescriptions if needed.

• 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.

• A patient ,supported by the practice, had developed SMILE a support group for post natal parents suffering from depression.

• A recent training course for staff was led by two teenage patients who had used the CAMHS (Children and Adolescents Mental Health Service) service.

Updated 8 September 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 including hospice staff, Macmillan nurses and district nurses.

• 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.

• Homeless people had the facility to register with a ‘practice address’ and put a plan in place to make future contact.

• A drug addiction service had been running for 15 years to help stabilise patients.

• Practice staff actively sought out and maintained a register of carers and patients were asked whether they were carers via a new patient questionnaire. A carer’s information board was maintained in the waiting room. The practice had written to all carers to ask if they would like to receive support from Carers UK.

• Patients who repeatedly did not attend appointments were reviewed at practice meetings.