Ribblesdale Medical Practice

Updated 13 March 2018

Dr Woodcock & Partners, Ribblesdale Medical Practices, Townside Primary Care Centre, 1 Knowsley Street, Bury, Lancashire BL9 0SN is located in Bury, Greater Manchester and provides general medical services to patients within the Bury Clinical Commissioning Group area.

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.ribblesdalemc.nhs.uk

Information taken from Public Health England placed the area in which the practice is located as number 6 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.

The practice is responsible for providing services to 7,447 patients. The practice offers direct enhanced services that include meningitis provision, the childhood vaccination and immunisation scheme, extended hours, support for patients with dementia and learning disabilities, influenza and pneumococcal immunisations and minor surgery.

Updated 13 March 2018

This practice is rated as Good overall. (Previous inspection January 2016 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

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 – Good

People with long-term conditions – Good

Families, children and young people – Good

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

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Dr Woodcock & Partners, Ribblesdale Medical Practices on 13 February 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 systems for managing medicines, including vaccines, medical gases, and emergency medicines and equipment minimised risks.

• The practice had a comprehensive programme of quality improvement activity and routinely reviewed the effectiveness and appropriateness of the care provided. The practice used information about care and treatment to make improvements.

• Staff worked together and with other health and social care professionals to deliver effective care and treatment.

• 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.

• The practice took complaints and concerns seriously and responded to them appropriately to improve the quality of care.

• Leaders had the experience, capacity and skills to deliver the practice strategy and address risks to it. They were knowledgeable about issues and priorities relating to the quality and future of services. They understood the challenges and were addressing them

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 May 2016

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

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Longer appointments and home visits were available when needed.
• Patients with long term conditions had a named GP and a structured annual review to check their health and medicine needs were being met.
• The practice had a robust recall system for patients living with long term conditions.
• When possible, patients with multiple long term conditions were offered one appointment which allowed all of the necessary reviews to be completed at once. 
• Where patients were identified as at risk of hospital admission, admission avoidance strategies such as care planning and rescue medication were implemented to support the patient with the management of their illness.

Updated 17 May 2016

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

• Immunisation rates were high for all standard childhood immunisations on comparison to national averages.

• 74.69% of patients with asthma, on the practice register, have had an asthma review in the preceding 12 months that includes an assessment of asthma control using the 3 RCP questions. The national average is 75.35%.
• 78.92% of women aged 25-64 had a  cervical screening test performed in the preceding 5 years. The national average is 81.83%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice worked collaboratively with community based services that supported children and families such as midwives, health visitors and school nurses.
• Weekly child health surveillance clinics were held at the practice along with immunisation clinics.
• All patients aged 12 years and under were offered a same day appointment to see a clinician if this was requested.
• General contraception and family planning advice was provided and along with a specialist family planning clinic for the insertion/removal of contraceptive implants and intrauterine contraceptive devices.
• A travel immunisation clinic was available.
• The practice provided a daily nurse practitioner led telephone triage service, which allowed the opportunity for a call-back service rather than a visit to the surgery.
• The practice offered an extended service at the weekend.

Updated 17 May 2016

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

• All patients over 75 years of age have a named GP of their choice.
• The building is accessible for patients with mobility problems.
• Influenza, pneumococcal and shingles vaccination clinics were available to patients over 65 years of age.
• Home visits were provided for housebound patients.
• As a part of the Avoiding Unplanned Admissions Scheme, elderly patients were identified if they are at risk of hospital admission, and admission avoidance strategies, such as care planning were implemented.
• All patients in care homes and with a diagnosis of dementia were offered a care plan.
• The practice staff and practice support pharmacist worked closely with older patients to support them in managing their medication.
• Regular and opportunistic multidisciplinary palliative care meetings were held to ensure coordinated and responsive care for patients nearing the end of their life.

Updated 17 May 2016

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 proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.
• The practice provided a daily nurse practitioner led telephone triage service, which allowed the opportunity for a call-back service rather than a visit to the surgery.
• The practice offered an extended service at the weekend.
• The practice provided NHS health checks and follow-up appointments for those patients identified at high risk of cardiovascular disease.
• Patients could order repeat medication and book appointments on line. 
• The practice promoted and welcomed registrations from patients who lived outside practice catchment area and who may work in the vicinity of the practice, improving access to primary care services.

Updated 17 May 2016

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

• 83.95% of patients diagnosed with dementia have had their care reviewed in a face to face meeting in the last 12 months.  This is comparable to the national average of 84.01%.
• 84.29% of patients with schizophrenia, bipolar affective disorder and other psychoses have had a comprehensive, agreed care plan documented in their record in the preceding 12 months. This is comparable to the national average of 88.47%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice carried out advance care planning for patients with dementia.
• The practice provided patients and their carers with information about community support groups.
• The practice had a system in place to follow-up patients who had attended A & E when they may have experiencing poor mental health.
• Staff were trained on how to support patients with mental health needs and dementia.
• Home visits are provided to housebound patients and those in residential homes, ensuring they receive the same necessary health checks.
• The practice has a mental health register and patients are invited for annual health checks.
• There is a named GP who leads on the assessment and management of dementia.

Updated 17 May 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients with a learning disability.  These patients were invited for annual health checks with longer appointments at the start or end of the day if this met their needs and prevented unnecessary distress and anxiety.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
• Staff knew how to recognise signs of abuse in vulnerable adults and children. 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 had been given the Pride in Practice award from the Lesbian, Gay, Bisexual and Transgender Foundation. This new initiative acknowledged the standard of service provided in lesbian, gay and bisexual healthcare. Training had been provided for staff in this area.
• The practice had a designated safeguarding lead for both children and adults, and all staff were fully aware of safeguarding procedures.
• The staff supported patients who were vulnerable by signposting them to support services, for example, carers groups.