Marton Medical Practice

Updated 1 September 2016

Marton Medical Practice is based in Blackpool, Lancashire. The practice is part of Blackpool Clinical Commissioning Group (CCG) and delivers services under a Personal Medical Services contract with NHS England.

The practice is located on the first floor of the Whitegate Health Centre on the outskirts of the town. There is easy access to the building and disabled facilities are provided. There is a car park and disabled parking places. There are four GP partners working at the practice, two male and two female. The practice also employs a salaried GP. The practice is a teaching practice for medical students. There are four female practice nurses, one health care assistant and a practice pharmacist. There is a practice manager and a team of administrative and reception staff.

The practice is open between 8am and 6.30pm, Monday to Friday. Extended hours are available until 8.45pm on Monday evenings.

When the practice is closed, patients are able to access out of hours services offered locally by the provider Fylde Coast Medical Services by telephoning 111.

There are 8820 patients on the practice list. The majority of patients are white British. The largest population group within the practice are patients aged under 18 years, 20.4% as opposed to the CCG average of 20.7%. All population group age profiles are comparable to CCG averages.

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.

Marton Medical practice was previously inspected using our old methodology in 2013.

Updated 1 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Marton Medical Practice on 7 July 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 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.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Ensure robust systems are implemented to ensure practice policies and procedures are reviewed and updated and relevant.

• Continue to roll out annual infection control training to all staff.

• Review staff meeting arrangements to ensure all staff receive important updates and information as appropriate.

• Promote the availability of the chaperone service to ensure patients are aware.

• Risk assess the need for a practice defibrillator.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 1 September 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.The nursing team offered a ‘one stop shop’ approach which meant patients were cared for holistically. Rather than managing conditions separately nurses focussed on the needs of the patient and where possible dealt with their needs in one appointment.

• Longer appointments and home visits were available when needed.
• Performance for diabetes related indicators was generally better than the national average. For example, blood measurements for diabetic patients showed that 87% of patients had well controlled blood sugar levels compared with the Clinical Commissioning Group (CCG) average of 83% and national average of 78%. The percentage of diabetic patients who had received an influenza immunisation was 100% compared to the CCG average of 96% and national average of 94%. The percentage of diabetic patients with a record of a foot examination was 93% compared to the CCG average of 94% and national average of 89%.

• Patients were offered an insulin initiation and follow up telephone advice service which was run by a practice nurse and supported by the lead GP. This meant that only the most complex patients needed to be referred to the hospital services for diabetic patients.

• Patients had open access via a direct number to the practice nursing team. During practice hours this meant nurses provided supportive care and advice to help reduce anxiety and offer reassurance.

• 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 1 September 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 81%, which was comparable to the CCG average of 82% and 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 1 September 2016

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

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

• The practice offered proactive, personalised care to meet the needs of the older people in its population. All patients over the age of 75 had a named GP.

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

• Older patients at risk of hospital admission and in vulnerable circumstances had care plans.

• The practice maintained a palliative care register and held three monthly meetings attended by a multidisciplinary team to enable sharing of information relating to patients to improve palliative and end of life care

Updated 1 September 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 reflected the needs for this age group.

• Extended hours surgeries were offered between 6pm and 8.45pm every Monday for working patients who could not attend during normal opening hours. Telephone consultations were also available.

Updated 1 September 2016

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

• Performance for mental health related indicators was similar to the national average. For example, 92% of people experiencing poor mental health had a comprehensive, agreed care plan documented in the record compared to the CCG average of 93% and the national average of 88%. Also 80% of patients diagnosed with dementia had their care reviewed in a face to face review, compared to the CCG average of 86% CCG and 84% nationally.

• The practice regularly worked with multi-disciplinary teams in the case management of patients 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 1 September 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.