John Street Medical Practice

Updated 30 August 2017

John Street Medical Practice, 1 John Street, Oldham, OL8 1DF provides primary medical services in Oldham from Monday to Saturday?.

The practice is now part of Hope Citadel Healthcare who provide primary care services in other practices in the Greater Manchester area. The practice benefits from high level support and leadership from the provider as well as access to human resources.

The surgery is open :

Monday to Friday 8am to 6.30pm.

Saturday 8am to 12 noon.

John Street Medical Practice is situated within the geographical area of Oldham Commissioning Group (CCG).

The practice has an Alternative Provider Medical Services (APMS) contract. The APMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.

John Street Medical Practice is responsible for providing care to 3761 patients.

The practice consists of one female GP and is currently being supported by a female advanced nurse practitioner, a focused care worker, practice nurse and health care assistant. The practice is supported by a patient services manager and an administration team that includes receptionists.

The provider was using locum GPs as they were in the process of recruiting additional GPs and nurse.

When the practice is closed patients are told to ring 111 which is the out of hour’s service provided by NHS 111.

The practice belongs to a group of local practices who provide access to a GP and practice nurse at evenings and weekends.

Updated 30 August 2017

Letter from the Chief Inspector of General Practice

John Street Medical Practice was acquired by Hope Citadel Healthcare in October 2016. We carried out an announced comprehensive inspection on 18 July 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 a system in place for reporting and recording significant events.
• The practice had clearly defined systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Some members of staff were trained translators in response to the ethnicity of the practice population.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available.
• Patients we spoke with said they found it easy to make an appointment with a GP with urgent appointments available the same day.
• 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 the requirements of the duty of candour.

We saw areas of outstanding practice:

• The practice employed focused care workers who were able to provide social and medical care for patients in need. Staff were also able to access counsellors if they required them.

• English lessons for female patients were provided by the focused care worker which would build confidence and help patients integrate into the community and increase employability.

The area where the provider should make improvement is:

• Identify patients caring for others and offer support as required.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 30 August 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.
• Data from the Quality and Outcomes Framework was unavailable for this new provider as the practice had been acquired in October 2016, published data would not be available until late 2018. However, they were able to show us that 91% of diabetic patients had a record of having had a foot examination and risk classification within the preceding twelve months compared to the national average of 87%.
• 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 named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 30 August 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.
• Care plans were in place for complex families and the practice worked closely with other agencies to resolve issues such as substance abuse, housing, debt, domestic violence and mental health. The practice were able to give us examples of positive outcomes for this group of patients.
• Immunisation rates were relatively high 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 premature babies and their families following discharge from hospital.
• 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 for acutely ill children and young people and for acute pregnancy complications.

Updated 30 August 2017

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

• The practice had very few elderly patients with 7% of the total patient list aged over 65 years.

• 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.
• The provider held internal meetings regarding these patients but they were not attended by any other agency despite being invited.

Updated 30 August 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.
• The focused care worker assisted families with housing issues and the completion of documentation.
• English speaking classes were held for female patients which would help build confidence and increase chances of employability including volunteer roles.

Updated 30 August 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.
• The practice told us that to date, 24% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which was lower than the national average of 83%.
• The practice specifically considered the physical health needs of patients with poor mental health and dementia.
• The provider employed a counsellor for patients who required this service.
• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.
• The practice told us that to date 76% of patients experiencing poor mental health had an agreed care plan which was below 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 30 August 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, asylum seekers, travellers and those with a learning disability.
• The practice staff included a focused care worker who provided social and medical care to its patients in need of this support. The practice were able to provide examples where they had assisted patients in finding homes and helped other patients with the benefits system.
• 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.