Cheetham Hill Primary Care Centre

Updated 20 April 2016

Cheetham Hill Primary Care Centre is located edge of Manchester city centre and is overseen by North Manchester Clinical Commissioning Group (CCG).

The practice is in a highly deprived area of Manchester, and treats a varied ethnically diverse population group. Patients groups ranged from white British to 40% of patients being South Asian, with up to 34 different languages spoken. The practice sees a high turnover of patients due to temporary living accommodation nearby, whilst also treating a high number of new immigrants arriving in Manchester. English is not the first language of many of the patients and a high portion of patients had poor educational skills.

The practice is a large two storey building which provides multiple services in the community and has community teams based there, which include: district nursing, community active case management service, mental health team, contraception and sexual health, community paediatrics, speech and language, orthoptist, alcohol team and a pharmacy.

The ground floor had full disabled entrance access with a large seated reception area; there was a second waiting area which held nurses’ treatment rooms. The GP consulting rooms were all located on the ground floor with a private room behind reception for patients needing to discuss confidentially. The first floor was accessible by stairs or lift and held a mix of staff offices and external treatment rooms with small seated waiting areas. There were disabled toilets on both floors, with the ground floor having baby changing facilities and a breast feeding room. All staffing areas were closed off to the public with a fob card entry system.

The practice has five GP partners and three salaried GPs (three males and five females) with one advanced nurse practitioner, three practice nurses and one healthcare assistant. Members of clinical staff are supported by one business manager and one assistant practice manager and reception and administrative staff. The practice is open from 8am until 6.30 pm Monday to Friday. Appointments times are between 9am and 6pm.

The practice has a Personal Medical Service (PMS) and a General Medical Service (GMS) contract with NHS England. At the time of our inspection in total 13,600 patients were registered.

Patients requiring a GP outside of normal working hours are advised to call “ Go-to- Doc” using the usual surgery number and the call is re-directed to the out-of-hours service. The surgery is part of Prime Ministers GP Access scheme offering extended hours and weekend appointments to patients and also hosts this service in house.

Updated 20 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cheetham Hill Primary Care Centre on 22 March 2016. Overall the practice is rated as good.

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

• There was a clear leadership structure and staff felt supported by management team. The practice proactively supported staff members to carry out their roles confidently and effectively, whilst developing and progressing staff further with training and development.
• Risks to patients were assessed and well managed. We saw evidence of a robust infection control process in place with a strong lead.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events which were clearly documented in minutes from meetings.
• 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.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw a number of examples of outstanding practice:

The practice initiated insulin in the community for patients with diabetes, something which is normally commenced in hospital. The practice had a strong and proactive clinical lead and a team who actively and effectively managed and monitored patients with diabetes. They used clinical audits and analysed outcomes to demonstrate improvement to patients’ quality of life. Staff had undertaken specific qualifications in diabetes to enhance and develop the skills in the team

The practice were proactive and responsive to understanding their multi-cultural and diverse population needs. This resulted in a research study with Lancashire Care NHS Foundation Trust, which explored psychological intervention for postnatal depression in the British mothers of south Asian origin. The practice had set up the BOOST programme which was a successful self-help group that met at the practice and supported new mothers who may be at risk of postnatal depression.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 20 April 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.
• All housebound patients with a chronic disease received face-to-face reviews.
• The percentage of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months (01/04/2014 to 31/03/2015) was 98% compared to the national average of 88%.
• Longer appointments and home visits were available when needed.
• All these 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 20 April 2016

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

• Appointments were available outside of school hours and the premises were suitable for children and babies.
• 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.
• The practice regularly liaised with health visitors who attended on a weekly basis.
• Immunisation rates were high for all standard childhood immunisations.
• We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 20 April 2016

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

• The practice had a close relationship with local care homes and offered support, training and signposting to help care staff in caring for their patients.
• The practice offered proactive, personalised care to meet the needs of the older patients in its population.
• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice participated in meetings with other healthcare professionals and social services to discuss any concerns.
• There was a named GP for the over 75s with longer appointments when required

Updated 20 April 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 reflects the needs for this age group.

Updated 20 April 2016

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

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• 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.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 20 April 2016

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

• The practice identified patients who may be in need of extra support; one example was the practice had 40 patients registered who were homeless.
• The practice supported many patients who were vulnerable, including asylum seekers, domestic violence victims, and alcohol users.
• The practice was proactive and met monthly to discuss patients who were vulnerable, isolated and at risk of admission to hospital. These patients were then followed up till they were no longer in crisis and their ability to self-care was improved.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• 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.