Park View Group Practice

Updated 7 October 2016

Park View Group Practice is part of the NHS Stockport Clinical Commissioning Group (CCG). Services are provided under a general medical services (GMS) contract with NHS England. The practice told us that they had 8431 patients on their register.

Information published by Public Health England rates the level of deprivation within the practice population group as four on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. Male life expectancy is 77 years in the practice geographical area and is below the England and CCG averages of 79 years. Female life expectancy at 83 years is reflective of local and England averages.

The practice is a partnership between five GPs (four male and one female). Four partners are registered with CQC and the fifth partner has commenced their application to be registered. The practice employs a practice manager, a project manager, a reception manager, and three practice nurses, including one advanced nurse practitioner, two health care assistants as well as reception and admin staff.

The practice is open between 8am to 6.30pm Monday to Friday, with extended hours for GP appointments on a Monday evening between 6.30 and 7.30pm and Friday mornings from 7.30am. Practice nurse and health care assistant appointments were available Tuesday, Wednesday and Thursday mornings from 7.30 to 8am. Weekend appointments are available that the Out of Hours provider Mastercall.

When the practice is closed patients are asked to contact NHS 111 for Out of Hours GP care.

The practice provides online access that allows patients to order prescriptions and request and cancel an appointment.

The practice building provides ground level access that is suitable for people with mobility issues.

The practice has been successful in obtaining funding via the Primary Care Infrastructure Fund to extend the practice to add three additional consultation rooms.

Updated 7 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Park View Group Practice on 1 September 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• The practice had strong and visible clinical and managerial leadership and governance arrangements.
• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment. The practice had a strong commitment to supporting staff training and development.
• Risks to patients were assessed and well managed. Some building assessments had not been undertaken.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Most patients were complimentary about the staff at the practice. Patients described the GPs as caring and professional.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Most patients said they found it easy to make an appointment with the GP and there was continuity of care, with urgent appointments available the same day.
• Easy read literature was used to invite patients with a learning disability for their annual review.
• The practice had the facilities and was well equipped to treat patients and meet their needs.
• Staff felt supported by management and demonstrated a clear understanding of the leadership structure.
• A patient participation group was not established but the practice used an accessible electronic tablet in reception where patients could comment on the service that they had received and a Facebook page had recently been set up for the practice.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw some areas of outstanding practice:

• The practice was committed to supporting patients with dementia more effectively and had undertaken a significant amount of work to improve their performance. For example, the practice had increased its dementia diagnosis rate from 55% to 81% between April 2014 and March 2015. The practice provided memory assessments and patients diagnosed with dementia had an agreed care plan in place. The practice implemented a shared protocol with the local memory clinic to provide better support locally to its patients. Reception staff were dementia friends and had received additional training in techniques for managing behaviours of people living with dementia.

The areas where the provider should make improvements are

• Implement assessments of the practice building for Legionella and asbestos.
• The clinical nursing team should attend the weekly clinical meeting to ensure they are kept up to date with clinical issues and significant event investigations.
• The planned action to develop the patient participation group should be implemented.
• Clinical protocols should be accessible to the clinical team.
• The practice manager should formalise their ‘to do’ list into a documented action plan to monitor progress in achieving its objectives.
• The practice should identify and maintain a list of patients who are also carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 October 2016

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

• The practice performed better than the national average in some of the diabetes indicators outlined in the Quality and Outcomes Framework (QOF) for 2014-2015. However, clinical exception reporting was higher than the Clinical Commissioning Group (CCG) and national averages. The practice stated the sudden closure of two GP practices during the period of 2014-2015 resulted in the addition of 800 plus patients to their register. This affected the clinical exception reporting rate.

• The practice encouraged patients to self refer to education programmes such as Expert for the management of diabetes and other long term conditions.

• Longer appointments and home visits were available when needed.

• All patients had a named GP and 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 7 October 2016

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 who were at risk, for example, children and young people who had a high number of A&E attendances.

• Immunisation rates were comparable to the locality for all standard childhood immunisations.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• Quality and Outcome Framework (QOF) 2014-15 data showed that practice performance was slightly below the Clinical Commissioning Group and the national averages. For example, 70% of patients with asthma, on the register, who had received an asthma review in the preceding 12 months (CCG 76% and national data 75%).

• The practice’s uptake for the cervical screening programme was 81%, similar to the CCG and the national average of 82%.

• The practice had been proactive in raising awareness of breast screening and with Public Health England had held a drop in session in May 2016 for women to attend. Between 45 and 50 women were seen.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 7 October 2016

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

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• Monthly multi-disciplinary team meetings were held in the local neighbourhood to review specific patients considered at high risk.

• The practice was proactive in supporting patients on the palliative care register and used an electronic communication tool (Electronic Palliative Care Coordination Systems (EPaCCS) to record information that was accessible to the Out of Hours provider and the local hospital.

• A member of staff had recently been trained as a cancer champion.

Updated 7 October 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 offered flexible surgery times including late night appointments on a Monday evening and early morning appointments Tuesday to Friday. Weekend appointments were available from the Out of Hours provider Mastercall.

• Telephone consultations were available.

• 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 7 October 2016

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

• Staff had a good understanding of how to support patients with mental health needs and dementia.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health. As a result of this monthly monitoring the practice had undertaken a significant amount of work to improve their performance and had increased dementia diagnosis rate from 55% to 81% between April 2014 and March 2015.

• The practice provided memory assessments and patients diagnosed with dementia had an agreed care plan in place.

• All administration staff were dementia friends and had received additional training in techniques for managing behaviours of people living with dementia.

• The practice was working closely with the local memory clinic to develop staff skills in GP practice so that better support was provided locally to people with dementia. A shared care protocol had been developed.

• The practice was proactive in signposting and supporting patients to self refer to Improving Access to Psychological Therapies (IAPT); to the charity ARC (Arts for Recovery in the Community) and prescribing exercise on prescription.

• Alerts were posted on patient electronic records to identify those who were assessed as high risk.

• 95% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan recorded in the preceding 12 months, which was above the CCG average of 91% and the national average of 88%.

• The practice worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

Updated 7 October 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 living in vulnerable circumstances including those with a learning disability.

• The practice used pictorial information to promote better understanding of the purpose of invitations to people with a learning disability for their annual health check.

• 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 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.