Archived: Manchester Medical

Updated 20 March 2017

Manchester Medical is situated in Moss Side in Greater Manchester. The practice is situated within a purpose built property in a residential area. There is a small amount of patient parking available on site and access to local transport links. The practice has six GPs, four male and two female, there is also a female locum GP, a practice nurse and two practice pharmacists and a phlebotomist. The practice is training and teaching practice for medical students, trainee pharmacists, foundation doctors, trainee GPs and return to work GPs. The practice has 7150 patients registered with approximately 1000 students registered.

The practice has a General Medical Services (GMS) contract with NHS England and is part of the NHS Central Manchester Clinical Commissioning Group (CCG).

The registered patient population are predominantly of white British background. The practice age profile demonstrates higher number of patients under 18 years old, and lower numbers of patients aged 65 and over in comparison to the local and national averages.

The practice has a similar proportion of patients with a long standing health condition at 52% compared to the CCG and national averages of 50% and 54% respectively.

Information published by Public Health England rates the level of deprivation within the practice population group as one on a scale of one to 10. Level one represents the highest levels of deprivation and level 10 the lowest.

Patients were able to ring the practice from 8am to 6pm (1pm on Wednesday) and will be called back the same day.The practice is open between 8.30am and 6pm Monday, Tuesday, Thursday and Friday the practice is closed between 12 noon and 2pm. The practice is open half day from 8.30am to 1pm on Wednesday. Telephone lines are open from 8am each day. Patients are able to attend the practice between 8:30am and 9.30ameach morning to join a sit and wait clinic and will be seen by a GP on the day.

There are also arrangements to ensure patients receive urgent medical assistance when the practice is closed. To access treatment outside of the practice opening hours patients are advised to contact Go-To-Doc or to contact the NHS 111 service to obtain healthcare advice or treatment.

Updated 20 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Manchester Medical Moss Side Health Centre, Monton Street, Moss Side, Manchester, M14 4GP on 10 January 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 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 offered patients consultations via skype. The patients we spoke with told us the service had improved access to consultations and enhanced overall access to a GP.

• The practice held a face to face GP led triage service every morning Monday to Friday. This was evaluated highly by patients and we were told all patients attending this service would be seen. Patients told us the GPs responded compassionately when they needed help and provided support when required.

• 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 areas of outstanding practice:

The practice team was forward thinking and part of local and national pilot schemes to improve outcomes for patients. For example:

• The practice offered patients consultations via skype. The patients we spoke with told us the service had improved access to consultations and enhanced overall access to a GP.

• The practice held a dedicated clinic held each Thursday afternoon for young people leaving care.

• One of the GPs was a former clinical commissioning lead and was instrumental in developing locally commissioned services. For example: the introduction of community intravenous therapy service. This service enabled patients who required intravenous (IV) antibiotics to be treated in the community rather than in hospital. This pilot scheme had been successful and was subsequently commissioned across the CCG area.

• Another GP was Deputy Clinical Director for Central Manchester CCG.

• Medication reviews were conducted six weeks before the month of Ramadan for those patients with diabetes who identify as Muslims, to ensure safety during fasting. Some Muslim diabetic patients did not wish to have blood tests during Ramadan and diabetic reviews were arranged outside of this month.

The areas where the provider should make improvement are:

• Retain interview notes within staff recruitment files.

• Improve the recording of significant events to demonstrate actions and learning to be able to identify trends more easily.

• Continue to identify and support those young patients who were also carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 20 March 2017

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

• Nursing and clinical pharmacy staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Longer appointments were available as standard 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 percentage of patients with diabetes, on the register, whose last measured total cholesterol (measured within the preceding 12 months) is 5 mmol/l or less was 67% which was below the CCG and national average of 82% and 80% respectively.
• 59% of patients with COPD who had a review undertaken including an assessment of breathlessness using the Medical Research Council dyspnoea scale in the preceding 12 months (01/04/2015 to 31/03/2016) which was below the CCG and national average of 89% and 90% respectively. During the inspection the practice provided unverified data to demonstrate this had increased to 81%.

• The practice conducted medication reviews six weeks prior to the month of Ramadan to ensure safety during fasting. Some Muslim diabetic patients did not wish to have blood tests during Ramadan and diabetic reviews were arranged outside of this month.

Updated 20 March 2017

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.
• 61% of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding 5 years (01/04/2015 to 31/03/2016) which was below the CCG average of 78% and national average of 81%.
• 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.

Updated 20 March 2017

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 had reviewed the needs of the older population and carers and introduced late lunch clinics from 3pm onwards, with longer appointments.

Updated 20 March 2017

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 20 March 2017

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

• 67% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months (2015/2016), which was worse than the CCG and national average of 89% and 84% respectively.

• 56% of patients diagnosed with schizophrenia, bipolar affective disorder and other psychoses whose alcohol consumption has been recorded in the preceding 12 months (01/04/2015 to 31/03/2016) which was significantly lower than both the CCG and national average of 89%.

• 46% of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive care plan documented in the record, in the preceding 12 months, agreed between individuals, their family and/or carers as appropriate. This was well below the CCG and national average of 89% and 88% respectively.

During the inspection the practice provided unverified data to demonstrate that the number of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive care plan documented in the record had increased to 71%.

• 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 20 March 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.
• 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 had high rates of female genital mutilation (FGM) and had good reporting mechanisms in place.
• The practice accepted registrations from patients who were homeless, of refugee status or recently released from secure institutions.
• The practice held a dedicated clinic held each Thursday afternoon for young people leaving care. This service provided support and advice regarding healthy living, sexual health and how to access health care services.