The Dale Medical Practice

Updated 2 January 2018

The Dale Medical Practice, 2nd Floor, Nye Bevan House, OL11 1DN is located in Rochdale, Greater Manchester and provides general medical services to patients within the Heywood, Middleton and Rochdale Clinical Commissioning Group area.

The practice website is www.thedalemedicalpractice.co.uk.

The practice is responsible for providing treatment to 2450 registered patients and offers direct enhanced services that include meningitis provision, the childhood vaccination and immunisation scheme, extended hours access, facilitating timely diagnosis and support for people with dementia, influenza and pneumococcal immunisations, learning disabilities, minor surgery, patient participation, rotavirus and shingles immunisation and unplanned admissions.

Information taken from Public Health England placed the area in which the practice is located as first on the deprivation scale of one to ten. (The lower the number the higher the deprivation). In general, people living in more deprived areas tend to have greater need for health services.

Updated 2 January 2018

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection as part of our inspection programme at The Dale Medical Practice on 11 April 2017 which was rated as good overall, however the key question responsive was rated as requires improvement.

The full comprehensive report for this inspection can be found by selecting the ‘all reports’ link for The Dale Medical Practice on our website at www.cqc.org.uk.

This inspection was a focused desk top inspection carried out on 18 December 2017 to confirm that the practice had carried out their plan to meet the requirements in relation to those identified in our previous inspection on 11 April 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as good with the key question responsive now rated as good.

Our key findings were as follows.

• The practice had installed a new telephone system which had reduced the time patients were kept on hold.
• The reception staffing structure had been changed to ensure there were sufficient staffing levels at peak times.
• The practice increased their core opening hours to 8am to 6.30pm and no longer closed on Wednesday afternoons.
• The practice receptionists had been trained to triage and signpost patients more effectively to the most appropriate service.
• The practice had carried out their own patient survey which had shown an improvement in patient satisfaction.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 18 May 2017

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

• Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.
• The percentage of patients with diabetes, on the register, whose last measured total cholesterol (measured within the preceding 12 months) was 5mmol/l or less was 84% compared to the CCG of 79% and the national average of 80%.
• 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. For example patients with COPD were offered personalised “Flare up” plans.
• 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 named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.
• The practice were involved in the CCG “Test Beds” initiative which helped patients self manage their long term conditions.

Updated 18 May 2017

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

• From the sample of documented examples we reviewed we found 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 relatively high for all standard childhood immunisations.
• 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. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.
• The practice had emergency processes, which included links with midwives and health visitors, for acutely ill children and young people and for acute pregnancy complications.

Updated 18 May 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.
• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.
• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.
• Where older patients had complex needs, the practice shared summary care records with local care services.
• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible.
• Dementia screening and seasonal immunisations were offered to all its older patients.
• The practice referred to the continence team, falls team and social services when required.

Updated 18 May 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, for example the practice worked with GP Care services to provide seven day access to a GP.
• The practice offered electronic prescribing which meant that a patient could nominate a pharmacy where the GP sends prescriptions to, making the whole process more efficient and convenient for the patient.
• 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 18 May 2017

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

• The practice carried out advance care planning for patients living with dementia.
• 100% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is above the national average.
• The practice specifically considered the physical health needs of patients with poor mental health and dementia whilst taking into account the patients cultural beliefs and ethnic understanding.
• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months was 100% which was above the CCG average of 87% and the national average of 89%.
• 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 18 May 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.
• At the end of April 2017 the Mayor of Rochdale was to attend the practice to launch it as a “Homeless Friendly Practice”. This meant that homeless patients would be able to register as a patient, use the practice address for correspondence and walk in to see a GP when required.
• 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 interviewed 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 offered comfort calls to its patients who were vulnerable.