Durnford Medical Centre

Updated 2 February 2017

Durnford Medical Centre provides primary medical services in Middleton near Manchester from Monday to Friday. The practice is open between 8am and 6pm. The first appointment of the day with a GP is 8.40am and the last appointment with a GP is 5.10pm.

Durnford Medical Centre is situated within the geographical area of Heywood, Middleton and Rochdale Commissioning Group (CCG).

The practice has a Personal Medical Services (PMS) contract. The PMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.

Durnford Medical Centre is responsible for providing care to approximately 9200 patients .

The practice consists of six GP partners one of whom is female, two practice nurses and two phlebotomists. The practice is supported by a practice manager and reception and administration teams. It is a training practice with two trainee GPs.

When the practice is closed patients are directed to the out of hour’s service.

The practice are part of a local federation in providing 8am to 8pm, seven days a week access to a GP in the local area.

The practice were awarded the Pride in Practice Gold Award from the LGBT Federation.

Updated 2 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Durnford Medical Centre on 12 January 2017. Overall the practice is rated as good.

The practice had been previously inspected on 20 January 2016. Following that inspection the practice was rated as requires improvement with the following domain ratings:

Safe – Requires Improvement

Effective – Requires improvement.

Caring – Good

Responsive – Requires improvement

Well Led – Requires Improvement

The practice provided us with an action plan detailing how they were going to make the required improvements.

The inspection on 12 January 2017 was to confirm the required actions had been completed and award a new rating if appropriate.

Following this re-inspection on 12 January 2017 our key findings across all the areas we inspected were as follows

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• The practice had increased its READ coding of the clinical system which had improved its achievement rates in the Quality Framework.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it difficult to get through to the surgery by telephone.
• 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 provider was aware of and complied with the requirements of the duty of candour.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 2 February 2017

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.
• The percentage of patients with diabetes, on the register, in whom the last IFCC-HbA1c was 64mmol/mol or less in the preceding 12 months was 75% compared to the CCG average of 77% and England average of 78%.
• One of the GPs was trained and held a weekly diabetic clinic with the practice nurse. This included the initiation of insulin.
• 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.
• Patients that had been diagnosed with asthma were offered personalised care plans for use in the case of an emergency.
• Since the last inspection the practice had shown an improvement in the number of patients who had had an asthma review in the preceding 12 months. The percentage had increased from 40% to 68% compared to the CCG average of 75%. The practice told us that this was due to an improvement and consistent READ coding by the clinicians.

Updated 2 February 2017

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. A member of staff had been identified to support the clinical lead for safeguarding and attended monthly meetings where patients at risk were discussed.
• Immunisation rates were relatively high 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.
• 80% of women aged between 25 and 64 had their notes recorded that a cervical screening test had been performed in the preceding five years which was comparable with the national average of 81%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 2 February 2017

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.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• Comfort calls were made by the practice for its vulnerable elderly patients.

Updated 2 February 2017

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.
• The practice had recently introduced a text message service to remind patients of their appointments. This had resulted in a reduction in patients not attending for their appointments.
• The practice had introduced electronic prescribing which enabled patients to nominate a pharmacy where the practice could send their prescriptions electronically making it more convenient for the patient.
• Telephone appointments were available for patients who were unable to attend the surgery.

Updated 2 February 2017

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

• 79% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average of 84%.
• 81% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in their record in the preceding 12 months. Although this is lower than the national average of 89% the number had increased from 53% at the last inspection.
• 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 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 2 February 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, military veterans and those with a learning disability.
• 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.
• Comfort calls were made by the practice for patients who were at risk or vulnerable.