Stanley Court Surgery

Updated 28 June 2016

Stanley Court Surgery is situated in a residential area of Burscough and occupies the purpose built Burscough Health Centre along with a neighbouring GP practice. There is car parking available outside the Health Centre and a ramp at the front entrance of the building to facilitate access for those experiencing difficulties with mobility.

The practice delivers services under a general medical services (GMC) contract with NHS England to 5363 patients, and is part of the NHS West Lancashire Clinical Commissioning Group (CCG). The average life expectancy of the practice population is in line with both CCG and national averages for males (79 years) and slightly above the CCG average for females (83 years for the practice as opposed to 82 years for the CCG, 83 years nationally). The age distribution of the practice’s patient demographic closely aligns with the national averages. A slightly higher proportion of the practice’s patients are in full time education or paid work; 65% compared to the CCG average of 60.5% and national average of 61.5%. The practice caters for a slightly lower proportion of patients with a long standing health condition (51.1% compared to the CCG average of 55.5% and national average of 54%).

Information published by Public Health England rates the level of deprivation within the practice population group as eight on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

The practice is staffed by four GP partners (three female and one male). The GPs are assisted by two practice nurses and a healthcare assistant. Clinical staff are supported by a practice manager, assistant practice manager and six other administrative and reception staff.

The practice is open Monday to Friday between the hours of 8:00am and 6:30pm, apart from Wednesdays when the practice closes at 1:00pm. Extended hours appointments are available each Monday evening until 8:00pm. Appointments are offered between 8:30am and 12:00 each morning, and from 3:30 until 5:30pm each afternoon, apart from Mondays when appointments are offered until 8:00pm, and Wednesdays when the surgery closes at 1:00pm. On a Wednesday afternoon when the practice is closed, cover is provided by the neighbouring practice that occupies the same health centre building. Outside normal surgery hours, patients are advised to contact the Out of hour’s service, offered locally by the provider OWLS CIC Ltd.

Updated 28 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Stanley Court Surgery on 10 May 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. Appropriate learning outcomes were identified following the analysis of 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.
• Patients said they found it easy to make an appointment with a named GP and 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.
• There was a reflective ethos in the practice and proactive changes were implemented to improve patient care.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

• The practice had made efforts to proactively improve communication channels with other healthcare providers following a patient’s referral on to secondary care. This included a faxback form beingsent in with referral documentation in order to facilitate timely and appropriate feedback regarding the outcome of the referral.

The areas where the provider should make improvement are:

• Update the recruitment policy to reflect the change to criteria around which staff require a Disclosure and Barring Service check.

• Ensure meeting minutes contain sufficient detail to provide a clear audit trail of the information disseminated to staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 June 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 diabetes related indicators was in line with the national average.

• 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 with complex needs had their review appointments coordinated so as to minimise the need to visit the surgery.

• The practice offered weekly anticoagulant clinics where patients’ bloods were tested and their anti-coagulant medicine reviewed and dose changed as required. This meant they did not need to attend a separate specialist anticoagulant clinic.

• 98% of patients taking four or more medicines had had their medication reviewed in the previous 12 months.

Updated 28 June 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 practice’s uptake for the cervical screening programme was 80%, which was comparable to the national average of 82%.

• 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 28 June 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.

• Multidisciplinary palliative care meetings were held every month to ensure those patients nearing the end of their lives were receiving the most appropriate care and treatment.

• Health checks were offered to those patients over the age of 75; 77% of these patients had received a health check in the previous 12 months.

• The practice had a specific protocol in place for identifying and supporting those patients who were frail.

Updated 28 June 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.

• Telephone consultations were available for those patients who were unable to attend the surgery in person and who needed health advice.

Updated 28 June 2016

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

• The percentage of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months was 80%, which is comparable to the national average of 84%.

• 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 is 97% compared to the national average of 88%. The practice were also able to show us current data (which was yet to be externally validated) that demonstrated that 100% of patients on the mental health register had care plans in place.

• 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 28 June 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 and carers.

• 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.