Archived: Adswood Road Surgery

Updated 7 October 2016

Adswood Road Surgery is part of the NHS Stockport Clinical Commissioning Group (CCG). Services are provided under a personal medical service (PMS) contract with NHS England. The practice has 4350 patients on their register.

Information published by Public Health England rates the level of deprivation within the practice population group as two on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. The average male life expectancy in the locality is 76 years compared to the CCG and England average of 79 years. The average female life expectancy for the locality is also 3 years below the CCG and England average at 80 years.

The practice’s patient population for the under 18 years of age at 29% is much larger than the local and England average of 20%. Further, the practice is located in an area that has a patient population with a higher rate of long standing health conditions (63% compared to 53% locally and 54% nationally) and there is a higher rate of unemployment at 9% compared to 5% locally and nationally.

The practice is a large adapted bungalow located on a main road in Adswood centre. The building provides ground level access, which is suitable for people with mobility issues. A hearing loop to assist people with hearing impairment is available. Some car parking is available at the practice and there is on street parking close by.

The practice is a registered partnership between three female GPs. One of the GP partners is on maternity leave. The practice employs a female salaried GP and uses regularly a male locum GP. The practice employs a practice manager, a reception supervisor, two practice nurses, one health care assistant as well as reception and admin staff.

The practice reception is open from 8.00am until 6.30pm Monday to Friday with early morning appointments available from 7.20am, two mornings each week and later evening appointments available until 7.10pm two evenings per week.

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 book and cancel appointments and order prescriptions.

Updated 7 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Adswood Road Surgery on 8 September 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 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 that they sometimes had to wait several days to book a routine appointment with a named GP. Despite this patients said they received continuity of care and they were complimentary about the GPs. Urgent appointments were available the same day and the GPs provided a telephone call back service to patients.
• 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 sought feedback from staff and patients, which it acted on. However, the practice confirmed that they could not get volunteers to join a patient participation group (PPG) or even an online patient reference group (PRG).
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Develop a documented business plan with action plans and timescales to strengthen the practice’s governance arrangements and provide a framework for monitoring progress in achieving its objectives.

• Review communication strategies with patients to promote a clearer understanding and explanation of why there are waits to get a routine GP appointment and why some patient appointments are late.

• Continue to try to recruit patients to a patient participation or reference group, to provide a forum for formal patient engagement.

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.

• Nursing staff supported by the GP partners had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• The practice’s performance was comparable to the Clinical Commissioning Group (CCG) and the England average in all five of the diabetes indicators outlined in the Quality and Outcomes Framework (QOF) for 2014/15. The lead practice nurse confirmed a small group of patients with diabetes were resistant to participating in reviews of their condition.

• The practice actively screened patient blood test results to identify those that were pre-diabetic. Those identified were invited in to an appointment to discuss the risk of developing diabetes and review lifestyle choices to mitigate this risk.

• The practice initiated insulin therapy on-site, so patients did not have to travel to attend the local hospital for this service.

• 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 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 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 Clinical Commissioning Group (CCG) 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.

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

• Quality and Outcome Framework (QOF) 2014/15 data showed that the practice’s performance for the percentage of women aged 25-64 who had received a cervical screening test in the preceding five years was 79% with a clinical exception reporting rate of 2%. This was comparable to the CCG average of 82% and 4% exception reporting rate and the England average of 82% and exception reporting rate of 6%.

• QOF data for 2014/15 showed that 78% of patients with asthma, on the register, had received an asthma review in the preceding 12 months compared to the CCG average of 76% and England average of 75%.

• We heard about positive examples of joint working with midwives, health visitors and school nurses.

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.

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

• Weekly visits to a local care home were undertaken by the same GP to promote continuity of care.

• 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 the 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 early morning appointments from 7.20am on Tuesdays and Thursdays and later evening appointments until 7.10pm on Wednesdays and Thursdays. Telephone consultations were available.

• The practice was proactive in offering online services such as booking and cancelling appointments and ordering prescriptions.

• The practice website also offered information on health promotion and screening.

Updated 7 October 2016

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

• Data from 2014/15 showed that 89% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was above the Clinical Commissioning Group (CCG) average of 87% and the England average of 84%.

• 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 better than the CCG average of 84% and the England average of 81%.

• 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 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 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 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.