Archived: Manor House Surgery Hadfield

Updated 22 March 2018

Manor House Surgery Hadfield is the registered provider and provides primary care services to its registered list of approximately 3200 patients. The practice delivers commissioned services under the General Medical Services (GMS) contract and is a member of Tameside and Glossop Clinical Commissioning Group (CCG).

The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities. The practice offers direct enhanced services that include meningitis provision, the childhood vaccination and immunisation scheme, facilitating timely diagnosis and support for people with dementia, influenza and pneumococcal immunisations, learning disabilities, minor surgery and rotavirus and shingles immunisation.

Regulated activities are delivered to the patient population from the following addresses:

82 Brosscroft

Hadfield

Derbyshire

SK13 1DS

The practice has a website that contains comprehensive information about what they do to support their patient population and the in-house and online services offered: www.manorhousesurgery.co.uk

The age profile of the practice population is broadly in line with the CCG averages. Information taken from Public Health England placed the area in which the practice is located in the seventh least deprived (from a possible range of between 1 and 10). 

Updated 22 March 2018

This practice is rated as Outstanding overall. (Previous inspection April 2015 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Outstanding

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Outstanding

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Outstanding

People with long-term conditions – Outstanding

Families, children and young people – Outstanding

Working age people (including those recently retired and students – Outstanding

People whose circumstances may make them vulnerable – Outstanding

People experiencing poor mental health (including people with dementia) Outstanding

We carried out an announced comprehensive inspection at Manor House Surgery Hadfield on 11 January 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw several areas of outstanding practice including:

• The practice used new tools and tests to improve outcomes for patients, for example C-reactive Protein (CRP) tests to reduce unnecessary antibiotic prescribing and introduced Exhaled Nitric Oxide (FeNO) to maximise asthma management for patients led by the advanced nurse practitioner. Since initiating FeNO early results showed improved symptom control, reduced exacerbations and hospital admissions. Of 203 tests audited, 33 patients had medication reduced, 11 patients had medication stopped, 50 patients had medication increased and 35 reported improvement in their symptoms.
• The practice worked closely with colleagues from adult social care (ASC) to support patients and their carers. We noted at any one time the practice was engaged jointly in coordinating the care of around 50 patients. We were told by the ASC the involvement of the practice was unique and the joint working enabled positive outcomes for patients. We were provided with numerous examples especially in relation to end of life care where joint working was crucial but also examples of enabling patient with dementia to remain at home or where patients in crisis due to mental health accessed swift coordinated response led by the GP.
• The practice initiated a minor injuries service with aim to provide the treatment direct to the presenting patient rather than referring on to the A&E for their management. Data provided by the practice showed of 77 patients treated under the scheme only 5 patients were sent to A&E, 45 were examined and given advice and 20 were sent direct for and x-ray.
• The practice worked closely with The Bureau (Glossop’s Voluntary & Community Network who work to support people to stay physically and socially active, improve mental wellbeing and live independently for longer.) to launch social prescribing (community navigation) as a single point of contact to offer support to patients with their health and social needs. The Bureau, hold a drop in session and booked appointment at the practice weekly. The aim was to reduce repeat attendances and multiple GP appointments where the issues were social. Data provided by the practice showed 23 social referrals have been made by GPs as well as staff promoting the drop in sessions. Evaluation by The Bureau in November 2017 showed Manor House Hadfield were actively engaged in social prescribing and had referred patients for a range of support including mobility, anxiety/depression, loneliness and social isolation.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 March 2018

Updated 22 March 2018

Updated 22 March 2018

Updated 22 March 2018

Updated 22 March 2018

Updated 22 March 2018