Waterfoot Medical Practice Also known as Waterfoot Group of Doctors

Updated 8 November 2016

Dr DM Doherty and Partners is a member of the East Lancashire Clinical Commissioning Group (CCG). General Medical Services (GMS) are provided under a contract with NHS England.

The surgery is situated in a purpose built health facility, which has been extended over the last ten years. The building is well designed and spacious with good facilities for those with restricted mobility. The practice offers a comprehensive range of services including minor surgery.

The practice is located in an area of high deprivation in Rossendale in Lancashire. Information published by Public Health England rates the level of deprivation within the practice population group as four on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

The practice currently has a patient list size of 9,160. The average life expectancy of the practice population is comparable with both CCG and national averages number for males at 77 years (compared to CCG 77 years and national average 79 years). Life expectancy for females is also comparable with CCG and national averages at 82 years (CCG 81 years and national average 83 years). Age groups and population groups within the practice population are comparable with CCG and national averages.

• 60% of patients have a long standing health condition (58% CCG)

• 55% are in paid work or full time education (57% CCG)

• 8% are unemployed (6% CCG)

There are seven GPs (four female and three male), who work at the practice. The practice is also a training practice for future nurses and GPs.

The nursing staff team consist of a male advanced nurse practioner (prescriber), two practice nurse and two health care assistants; all of whom are female. There is a practice manager, and a team of reception and administrative staff who oversee the day to day running of the practice.

The practice is open Monday to Friday 8am to6:30pm, with extended opening hours Tuesday 6.30pm to 8pm and Friday 7.15am to 8am (pre booked appointments only.)

In addition to pre-bookable appointments that could be booked up to six weeks in advance, the practice has urgent appointments daily.

When the practice is closed out of hours services are provided by East Lancashire Medical Services and can be contacted by telephoning NHS 111.

Updated 8 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr DM Doherty and Partners on 19 September 2016. Overall the practice is rated as good for providing safe, effective, caring, responsive and well-led care for all of the population groups it serves.

Our key findings across all the areas we inspected were as follows:

• Staff had a comprehensive understanding of the needs of their practice population and were flexible in their service delivery to meet patient demands.

• There was evidence of an all-inclusive team approach to providing services and care for patients.

• Staff had the skills, knowledge and experience to deliver effective care and treatment.

• The practice promoted a culture of openness and honesty. There was a nominated lead for dealing with significant events.

• All staff were encouraged and supported to record any incidents using the electronic reporting system. There was evidence of good investigation, learning and sharing mechanisms in place.

• Patients’ needs were assessed and care was planned and delivered following local and national care pathways and National Institute for Health and Care Excellence (NICE) guidance.

• Risks to patients were assessed and well managed.

• There was a safeguarding lead in place and robust systems to protect patients and staff from abuse.

• The practice sought patient views about how improvements could be made to the service, through the use of patient surveys, the NHS Friends and Family Test and engagement with patients and their local community.

• There was a clear leadership structure, staff were aware of their roles and responsibilities and told us the GPs were accessible and supportive.

• The practice complied with the requirements of the duty of candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment).

We saw two areas of outstanding practice

• The practice had piloted and introduced a GP-led allergy testing clinic in response to long waiting lists at the hospital. Nursing staff were trained up to support the GP.

• A military veteran’s project had been introduced to identify patients who required support and signpost them to additional services.

• The practice is piloting a GP led ear, nose and throat (ENT) service in response to long hospital waiting lists. It has been running for twelve months and is available to all local practices to use.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 8 November 2016

The practice is rated as good for the care of people with long term conditions.

• The practice nurse had lead roles in the management of long term conditions, supported by the GPs. Annual reviews were undertaken to check patients’ health care and treatment needs were being met.

• The practice maintained a register of patients who were a high risk of an unplanned hospital admission. Care plans and support were in place for these patients.

• The practice had a same day access policy for those patients who experienced deterioration in their condition. Longer appointments and ‘one stop clinics’ were in place to support patients to minimise unnecessary repeated appointments.

• A named GP lead was in place for those patients taking cytotoxic medications to ensure robust system of monitoring.

• An in house phlebotomy service was provided.

• 84% of patients diagnosed with asthma had received an asthma review in the last 12 months, which was higher than 76% locally and 75% nationally.

• 93% of patients diagnosed with chronic obstructive pulmonary disease (COPD) had received a review in the last 12 months, compared with 90% both locally and nationally.

• Online access was being trialled to help diabetic patients monitor bloods.

• 98% of newly diagnosed diabetic patients had been referred to a structured education programme in the preceding 12 months (CCG average 87%, national average 90%)

Updated 8 November 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.

• The practice worked with midwives and health visitors to support the needs of this population group. For example, the provision, ante-natal, post-natal and child health surveillance clinics.

• A weekly baby clinic was held at the practice with a GP and practice nurse in attendance. Immunisation rates were relatively high for all standard childhood immunisations.

• A dedicated vaccination recall lead was in place to ensure children who did not attend vaccination appointments were followed up.

• A dedicated baby-changing and breast-feeding room was provided at the practice.

• Patients and staff told us children and young people were treated in an age-appropriate way and were recognised as individuals.

• Appointments were available outside of school hours and the premises were suitable for children and babies. Same day access was available for all children under the age of twelve.

• Childhood immunisations were offered in line with the public health programme. Uptake rates for all children aged eight weeks to 5 years were between 91% and 98%.

• Family planning clinic was held every two weeks at the practice in addition to GPs providing comprehensive family planning support.

Updated 8 November 2016

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

• Proactive and responsive care were provided to meet the needs of the older people in its population.
• Registers of patients who were aged 75 and above and also the frail elderly were in place to ensure timely care and support were provided. Health checks were offered for all these patients.
• Double appointments were standard for the over 85 year olds.
• Immunisation and phlebotomy services were provided for housebound patients.
• Close relationships with local nursing homes and residents with care plans given direct number to contact practice.
• The practice worked closely with other health and social care professionals. These included local integrated neighbourhood teams, multi-disciplinary care teams and a consultant geriatrician.

Updated 8 November 2016

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these patients 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 pre-bookable, same day and online appointments. They also provided extended hours appointments during the week, early morning and evening.
• Telephone consultations and text message reminders were offered and prescriptions could be ordered online and collection arranged from a nominated pharmacy.
• The practice offered a range of health promotion and screening that reflected the needs for this age group.
• Health checks were offered to patients aged between 40 and 74 who did not have a pre-existing condition.
• Travel health advice and vaccinations were available.

Updated 8 November 2016

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

• Patients and/or their carer were given information on how to access various support groups and voluntary organisations.

• The practice had developed comprehensive care plans for patients with dementia.

• All staff had attended dementia awareness training.

• Data showed that 96% of patients diagnosed with dementia and 95% of patients who had a complex mental health problem, such as schizophrenia, bipolar affective disorder and other psychoses, had received a review of their care in the preceding 12 months. These were both higher than the national averages of 84% and 88% respectively.

• Same day appointments or phone consultations were available for patients experiencing poor mental health.

Updated 8 November 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• Staff knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.

• We saw there was information available on how patients could access various local support groups and voluntary organisations.

• A carer’s support group was held at the practice every two weeks.

• There was a named GP and named nurse for patients with learning disabilities.

• The practice maintained good links with the local learning disabilities team.

• Annual reviews for patients with a learning disability were provided where the patient preferred for example at their home or at the practice. A dedicated telephone number and email was provided to ensure a prompt response.

• The practice had worked with a local home for adults with a learning disability and involved them in a gardening project at the practice to ensure patients had a relaxing and peaceful place to wait if they were anxious whilst waiting at the practice.

• A military veteran’s project had been introduced to identify patients who required support and signpost them to additional services.