Dallam Lane Medical Centre

Updated 30 October 2017

Dallam Lane Medical Centre is located in Warrington, Cheshire. The practice was providing a service to approximately 2,800 patients at the time of our inspection.

The practice is situated in an area with higher than average levels of deprivation when compared to other practices nationally. The percentage of patients with long standing health conditions is higher than average when compared to other practices nationally. The percentage of patients with health related problems in daily life and caring responsibilities is similar to national averages.

The practice is run by two GP partners (1 male and 1 female). There is one practice nurse, one health care assistant, a practice manager and a team of reception and administration staff.

The practice is open from 8am to 7pm Mondays, Tuesdays and Thursdays and 8am to 6.30pm Wednesdays and Fridays. Patients can access appointments at a local Health and Wellbeing Centre up until 8pm in the evenings Monday to Friday, and from 8am to 8pm Saturdays and 8am to 2pm on Sundays, through a pre-booked appointment system. Outside of practice hours patients can also access the Bridgewater Trust for primary medical services.

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 General Medical Services (GMS) contract and offered a range of enhanced services for example; childhood vaccination and immunisation, influenza and pneumococcal immunisations, facilitating early diagnosis and support to patients with dementia and avoiding unplanned hospital admissions.

Updated 30 October 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dallam Lane Medical Centre on 5 September 2017. 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 carried out appropriately 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.

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

• Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

• The appointments system was flexible to accommodate the needs of patients. Urgent appointments were available the same day and routine appointments could be booked in advance.

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

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

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

• 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).

The areas where the provider should make improvement are:

• Review the arrangements for checking emergency medicines and fridge temperatures.

• Carry out a risk assessment in response to the results of the infection prevention and control audit.

• Ensure staff training records are kept up to date to demonstrate the training provided and readily identify any shortfalls in training.

• Undertake work to increase the number of identified carers to ensure these patients are provided with information about the support available to them.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 30 October 2017

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.

• Patients living with long term conditions underwent regular, structured health reviews.

• Patients with several long term conditions could be offered a single, longer appointment to avoid multiple visits to the surgery.

• Data from 2015 to 2016 showed that the practice was performing in comparison with other practices nationally for the care and treatment of people with chronic health conditions.

• The practice held regular 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.

Updated 30 October 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 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.

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

• Immunisation rates were comparable to the national average for all standard childhood immunisations. Non-attendance of babies and children at vaccination clinics was monitored and staff told us they would report any concerns they identified to relevant professionals.

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

Updated 30 October 2017

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 outcomes for patients locally and nationally.

• 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.

Updated 30 October 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 open from 8am to 7pm three days per week and 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 and 8am to 2pm on Sundays, through a pre-booked appointment system.

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

• 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 requests for repeat prescriptions. Electronic prescribing was also provided.

Updated 30 October 2017

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 an 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 comparable to local and national averages.

• The practice referred patients to appropriate services such as psychiatry and counselling services.

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

• Patients experiencing poor mental health were informed about how to access various support groups and voluntary organisations.

Updated 30 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 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.

• 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 provided access and facilities for people who were disabled.

• Information and advice was available about how patients could access a range of support groups and voluntary organisations.

• Patients with drug or alcohol dependency were referred to local support services.