Archived: Wilbraham Surgery

Updated 27 May 2016

Wilbraham Surgery is based in Manchester. It is part of the NHS Central Manchester Clinical Commissioning Group (CCG) and has 4079 patients. The practice provides services under a General Medical Services contract, with NHS England.

Information published by Public Health England rates the level of deprivation within the practice population group as level five on a scale of one to 10. Level one represents the highest levels of deprivation and level 10 the lowest. Male and female life expectancy in the practice geographical area is 77 years for males and 82 years for females, both of which are similar to the England average of 79 years and 83 years respectively. The numbers of patients in the different age groups on the GP practice register were generally similar to the average GP practice in England. There were a higher number of patients aged 25 to 34 years.

The practice had a lower percentage (53.1%) of its population with a long-standing health condition than the England average (54%). The practice had a higher percentage (66.3%) of its population with a working status of being in paid work or in full-time education than the England average (61.5%). The practice had a higher percentage (6%) of its population with an unemployed status than the England average (5.4%).

Services are provided from a converted building with disabled access and on street parking. The practice has a number of consulting and treatment rooms. The service is led by a male GP who is supported by a practice manager, a practice nurse as well as an administration team including a number of reception / administrative staff who also cover other duties such as dealing with samples and drafting prescriptions.

The practice is open between 8.30am to 12pm and 2pm to 6pm Mondays, Tuesdays, Wednesdays and Fridays and from 8.30am to 12pm on Thursdays. Patients are able to book appointments from 8.30am. Patients can telephone the surgery before 10am for an appointment for the morning surgery. Evening surgeries between 4pm and 5.40pm are available by appointment only but medical emergencies are accommodated. Late evening surgeries are available on Tuesday between 6.30pm and 7.15pm. These surgeries are by appointment only to accommodate patients unable to attend during normal working hours. Family planning/well woman clinics are carried out on the first two Mondays of every month from 4.00pm to 5.30pm with no appointment required. Out of hours cover is provided by Go to Doc and patients can access the local walk in centres and the NHS 111 service.

Updated 27 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection on 06 April 2016. Overall the practice is rated as good.

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.
• 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.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• 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 practice proactively sought feedback from staff and patients, which it acted on.

The provider should consider the following improvements:

• There was no defibrillator available on the premises. The provider should consider creating a formal risk assessment for all staff to follow in emergency situations.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 27 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.

• Performance for the five diabetes related indicators was below the national average.

• 85.29% of patients with diabetes had received an influenza immunisation compared to the national average of 94.45%.
• A record of foot examination was present for 87.31% compared to the national average of 88.3%.
• Patients with diabetes in whom the last blood pressure reading (measured in the preceding 12 months) was 140/80 mmHg or less was 76.3% compared to the national average of 78.03%.
• Patients with diabetes whose last measured total cholesterol (measured within the preceding 12 months) was 5 mmol/l or less was 79.1% compared to the national average of 80.53%.
• The percentage of patients with diabetes, on the register, in whom the last IFCCHbA1c was 64 mmol/mol or less in the preceding 12 months was 64.92% compared to the national average of 77.54%.

• 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 27 May 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 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.
• The percentage of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding 5 years (01/04/2014 to 31/03/2015) was 81.8%, which was the same as the national average of 81.8%.
• 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 27 May 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.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice had a register of 242 patients over 75 with a named GP and had signed up to the Care Home Initiative.
• The GP looked after a care home with a total of 17 patients by undertaking a weekly ward round to ensure that patients at risk of unplanned admissions were assessed. The care staff at the home had the office number to ring for any problems or concerns with their residents.
• The practice had 74 housebound older patients who were offered annual reviews in their own homes. The practice nurse was available throughout the week to visit for any bloods or tests as required.

Updated 27 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 reflects the needs for this age group.
• The practice offered appointments at early evening surgeries during the week and an extended surgery on a Tuesday evening to 7.30pm.
• Telephone appointments were available if patients wished to discuss test results urgent concerns and who may have difficulty attending surgery due to work commitments.

Updated 27 May 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 carried out advanced 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 percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record in the preceding 12 months was 40% compared to the national average of 88.47%.
• The percentage of patients diagnosed with dementia whose care had been reviewed face to face in the preceding 12 months was 83.87% compared to the national average of 84%.
• 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 27 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 living in vulnerable circumstances including homeless people, travellers and those with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• 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.