Archived: RK Medical Practice

Updated 18 January 2018

RK Medical Practice is situated in a purpose built health centre at 171 Brownley Rd, Wythenshawe Manchester, M22 4GL. This facility is shared with another GP practice and various community health services, including the district nursing team. The practice has 4500 registered patients and is part of Manchester Clinical Commissioning Group (CCG). Services are provided under a General Medical Services contract with NHS England.

The practice has two male GPs, one the registered provider, the other a salaried GP. There is also a long term female locum GP employed. The practice staff consists of a practice manager, a practice nurse, a community practice nurse and a number of reception and administration staff.

The practice has appropriate facilities, disabled access and car parking. There are three consultation rooms and two treatments rooms utilised by the practice.

The surgery is open from 8am until 6:30pm Monday to Friday and is also a part of a federation of GP practices who provide extended hours cover in the area between 6pm and 8pm, Monday to Friday, as well as on Saturday and Sunday. Patients are able to attend appointments at a small number of local health centres as part of this arrangement.

Out of hours services are provided by Go to Doc via NHS 111.

The practice is a teaching practice, supporting medical students.

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

Male and female life expectancy in the practice geographical area is 74 years for males and 77 years for females, both of which are below the England average of 79 years and 83 years respectively. The numbers of patients in the different age groups on the GP practice register is generally similar to the average GP practices in England. The practice has a higher percentage (60.5%) of its population with a long-standing health condition when compared to the local CCG average (51%)and the England average (53.2%). The practice percentage (49%) of its population with a working status of being in paid work or in full-time education is below the CCG average (66%) and the England average (62%). The practice percentage (16.8%) of its population with an unemployed status is above the CCG average (6.9%) and the England average of (5%).

Updated 18 January 2018

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at RK Medical Practice on 31 July 2017. The overall rating for the practice was Good, with requires improvement for the key question providing effective services. The full comprehensive report on the July 2017 inspection can be found by selecting the ‘all reports’ link for RK Medical Practice on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 8 January 2018 to confirm that the practice had achieved improvements to patient outcomes. This report covers our findings in relation to those additional improvements made since our last inspection.

Overall the practice is rated as Good,with the effective domain now rated Good

Our key findings were as follows:

• The practice had sustained an improvement in clinical outcomes for patients

• The introduction of the community practice nurse maximised the contact with patients.

• The management of patients with long term conditions had improved with an increase in patient reviews.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 October 2017

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

• GPs and nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.

• There had been some improvement in clinical outcomes in respect of the management of all long term conditions. Unverified data provided by the practice showed improvement and work needed to be continued to improve patient outcomes.

• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.

• There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health.

• All these patients had a named GP and there was a system to recall patients for a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care

Updated 10 October 2017

The practice is rated as good for the care of families, children and young people.

• There were systems 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 accident and emergency (A&E) attendances.

• Immunisation rates were good for all standard childhood immunisations.

• Patients told us, on the day of inspection, that children and young people were treated in an age-appropriate way and were recognised as individuals.

• The practice provided support for new mothers and their families following discharge from hospital, giving early information on vaccinations and how to best access help and advice if the baby became ill. This was also to try to help reduce A&E attendances.

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

• The practice worked with midwives, health visitors and school nurses to support this population group.

Updated 10 October 2017

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

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.

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

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs. This was improved by the practice employing a community practice nurse whose role was specifically for the review and management of house bound patients, patients who lived in care homes and elderly frail patients.

• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.

Updated 10 October 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these populations 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.

• Patients could access extended hours appointments until 8.00pm seven days per week, via the federation arrangements for working patients who could not attend during normal opening hours. This was for both GP and nurse appointments.

Updated 10 October 2017

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

• The practice carried out care planning for patients living with dementia.

• At the last inspection data indicated 55% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was worse than the CCG average of 79% and national average of78%. Unverified data demonstrated that this has improved to 99%.

• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.

• Patients at risk of dementia were identified and offered an assessment.

• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.

• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

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

Updated 10 October 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, travellers and those with a learning disability.

• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.

• 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 had information available for vulnerable patients about how to access various support groups and voluntary organisations.

• Staff we spoke with knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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 Military Veterans policy and signposted these patients to more specialised health and well-being support.