Folly Lane Medical Centre Also known as Dr Plumb and Partners

Updated 21 November 2016

Folly Lane Medical Centre is located in Warrington, Cheshire. The practice was providing a service to approximately 10,300 patients at the time of our inspection.

The practice is part of Warrington Commissioning Group (CCG). The practice is situated in an area with high levels of deprivation when compared to other practices nationally. The percent of patients with a long standing health condition is 68% which is higher than the national average of 54%.

The practice is run by six GP partners. There are an additional two salaried GPs. (Three male and five female). There are four practice nurses, one health care assistant, a practice manager and a team of reception/administration staff. The practice is open from 8am to 6.30pm Monday to Wednesday and 7am to 6.30 Thursdays and Fridays. The practice had signed up to providing longer surgery hours as part of the Government agenda to encourage greater patient access to GP services. As a result patients could access a GP at a Health and Wellbeing Centre in the centre of Warrington from 6.30pm until 8pm Monday to Friday and between 8am to 8pm Saturdays. This was by pre-booked appointment.

Outside of practice hours patients can access the Bridgewater Trust for primary medical services.

The practice is a training practice for foundation year 2 (F2) doctors completing a primary care placement and for GP specialist trainees. They also host medical students.

Patients can book appointments in person, via the telephone or online. The practice provides telephone consultations, pre-bookable consultations, urgent consultations and home visits. The practice treats patients of all ages and provides a range of primary medical services.

The practice has a Personal Medical Services (PMS) contract. The practice provides a range of enhanced services, for example: extended hours, childhood vaccination and immunisation schemes and checks for patients who have a learning disability.

Updated 21 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Folly Lane Medical Centre on 17 August 2016. 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 report incidents and near misses.

• Significant events had been investigated and action had been taken as a result of the learning from events.

• Systems were in place to deal with medical emergencies and staff were trained in basic life support.

• There were systems in place to reduce risks to patient safety. For example, infection control practices were good and there were regular checks on the environment and on equipment used.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.

• Feedback from patients about the care and treatment they received from clinicians was very positive.

• Data showed that outcomes for patients at this practice were comparable to outcomes for patients locally and nationally.

• Staff felt well supported and they were kept up to date with appropriate training. Staff we spoke with told us they had the skills, knowledge and experience to fulfil their roles and responsibilities.

• Patients told us they were treated with dignity and respect and they were involved in decisions about their care and treatment.

• Patients said they found it easy to make an appointment and there was continuity of care.

• Urgent appointments were available the same day and routine appointments could be booked in advance.

• The practice had good facilities, including disabled access. It was well equipped to treat patients and meet their needs.

• Information about services and how to complain was available. Complaints had been investigated and responded to in a timely manner.

• The practice had a clear vision to provide a safe and high quality service.

• There was a clear leadership and staff structure and staff understood their roles and responsibilities.

• The practice provided a range of enhanced services to meet the needs of the local population.

• The practice sought patient views about improvements that could be made to the service. This included the practice having and consulting with a patient participation group (PPG).

Areas where the provider should make improvements are;

• Ensure patients are provided with accurate and sufficiently detailed information about how they can make a complaint and what action they can take if they are not satisfied with the outcome of a complaint.

• Ensure all required personnel documents are maintained on file for all members of staff’

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 November 2016

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

• The practice held information about the prevalence of specific long term conditions within its patient population. This included conditions such as diabetes, chronic obstructive pulmonary disease (COPD), cardio vascular disease and hypertension. The information was used to target service provision, for example to ensure patients who required immunisations received these.

• Regular, structured health reviews were carried out for patients with long term conditions. GPs had lead roles in chronic diseases and practice nurses held dedicated lead roles for chronic disease management. As part of this they provided regular, structured reviews of patients’ health. Patients with several long term conditions were offered a single, longer appointment to avoid multiple visits to the surgery.

• Patients with asthma or COPD had personalised care plans.

• Data from 2014 to 2015 showed that the practice was performing in comparison with or better than other practices nationally for the care and treatment of people with chronic health conditions such as diabetes.

• Home visits were available for patients with long term conditions when these were required.

• The practice held multi-disciplinary meetings to discuss patients with complex needs and patients receiving end of life care.

• Patients were provided with advice and guidance about prevention and management of their health and were signposted to support services.

• A designated member of staff was a ‘public health champion’ with an aim to improve screening rates across the patient population.

Updated 21 November 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 those who were at risk, for example, children and young people who had a high number of A&E attendances.

• A GP was the designated lead for child protection.

• Staff we spoke with had appropriate knowledge about child protection and they had ready access to safeguarding policies and procedures.

• A regular meeting was held between the safeguarding lead and health visitors to share information and concerns for patients’ welfare.

• Family planning and contraceptive services were provided and there was a designated GP lead for this.

• Child surveillance clinics were provided for 6-8 week olds.

• Immunisation rates were comparable to the national average for all standard childhood immunisations. The practice monitored non-attendance of babies and children at vaccination clinics and reported any concerns appropriately.

• The percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed in the preceding five years was 82% which was comparable to the national average of 81%.

• Babies and young children were offered an appointment as priority and appointments were available outside of school hours.

• The premises were suitable for children and babies and baby changing facilities were available.

Updated 21 November 2016

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

• The practice offered proactive, personalised care and treatment to meet the needs of the older people in its population.

• The practice kept up to date registers of patients with a range of health conditions (including conditions common in older people) and used this information to plan reviews of health care and to offer services such as vaccinations for flu.

• Nationally reported data showed that outcomes for patients for conditions commonly found in older people were similar to or better than local and national averages.

• GPs carried out regular visits to local care homes to assess and review patients’ needs and to prevent unplanned hospital admissions.

• Home visits and urgent appointments were provided for patients with enhanced needs.

• The practice used the ‘Gold Standard Framework’ (this is a systematic evidence based approach to improving the support and palliative care of patients nearing the end of their life) to ensure patients received appropriate care.

• A number of GPs held lead roles in elderly care including for those with dementia, and those with long term conditions.

• All patients over the age of 75 had a named GP.

• The practice was running a ‘care co-ordination’ pilot to ensure more vulnerable patients were assessed and reviewed on a regular basis.

Updated 21 November 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.

• Early morning appointments were available two mornings per week.

• Saturday and early morning flu vaccination clinics were provided.

• Telephone consultations were provided and patients therefore did not always have to attend the practice in person

• Patients could access appointments at a local Health and Wellbeing Centre up until 8pm in the evenings Monday to Friday, and from 8am to 8pm Saturdays, through a pre-booked appointment system.

• The practice provided a full range of health promotion and screening that reflected the needs of this age group.

• The practice was proactive in offering online services including the booking of appointments and request for repeat prescriptions. Electronic prescribing was also provided.

Updated 21 November 2016

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

• The practice held a register of patients experiencing poor mental health and these patients were offered a two stage annual review of their physical and mental health.

• Data about how people with mental health needs were supported showed that outcomes for patients using this practice were similar to outcomes for people locally and nationally.

• The practice had a designated lead for mental health.

• The practice referred patients to services such as psychiatry and counselling services and patients were also informed about how to access support from other services.

• A system was in place to follow up patients who had attended accident and emergency and this included where people had been experiencing poor mental health.

• Processes were in place to prompt patients for medicines reviews at intervals suitable to the medication they were prescribed.

• The practice was proactive in supporting patients residing in two local mental health services, one of which was a psychiatric hospital. The support involved regular visits and included reactive acute care and proactive care planning. Patients at these services had a named GP. The practice reported that they knew these patients well and that this provided good continuity of care particularly for patients experiencing an acute mental health crisis.

Updated 21 November 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 in order to provide the services patients required. For example, a register of people who had a learning disability was maintained to ensure patients were provided with an annual health check and to ensure longer appointments were provided for patients who required these.

• The practice had a designated lead for patients with a learning disability.

• Multi-disciplinary meetings were held to review the care and treatment provided to vulnerable patients.

• 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 was accessible to people who required disabled access and facilities and services such as a hearing loop system (used to support patients who wear a hearing aid) and translation services were available.

• Information and advice was available about how patients could access a range of support groups and voluntary organisations. The practice hosted the Citizens Advice Bureau on a weekly basis.