The Brooke Surgery

Updated 24 August 2016

The Brooke Surgery provides primary medical services in Hyde, Tameside from Monday to Friday. The surgery is open:

Monday: 8.00am to 6.30pm

Tuesday: 8.00am to 6.30pm

Wednesday: 8.00am to 6.30pm

Thursday: 8.00am to 9.00pm

Friday: 8.00am to 6.00pm

Appointments with a GP are available 8:30am to 11:00am and 9:00am to 11:30am. An on call GP is available from 8:00am. The afternoon surgery is from 3:00pm to 5:30pm. Appointments are also available from 6:30pm to 9:00pm Thursday evenings. The practice also participates in a local out of hours scheme in which patients are able to access GP appointments at a local hub evenings and weekends.

The practice has a General Medical Services (GMS) contract. The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.

Hyde is situated within the geographical area of Tameside and Glossop Clinical Commissioning Group (CCG).

The Brooke Surgery is responsible for providing care to 10453 patients.

The practice consists of seven GPs, four of whom are partners. Three of the GPs are female. The practice employed a nurse practitioner, practice nurses, pharmacist and health care assistant and a newly appointed wellbeing co-ordinator. The practice was also a training practice and at the time of our inspection there was one trainee GPs. The practice is supported by a practice manager, deputy manager, administration manager, senior receptionist, receptionists and administrators.

When the practice is closed patients are directed to the out of hours service, Go-To-Doc via 111.

Updated 24 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Brooke Surgery on 8 July 2016. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed, including those relating to recruitment checks.

• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example the impact of the work carried out by the well-being champion, healthy living project and ward rounds within residential and nursing homes.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• Data showed patient outcomes were in line with or above those locally and nationally.
• Feedback from patients about their care was consistently and strongly positive.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a result of feedback from patients. This included significant renovation of the reception and waiting areas.

• Information about services and how to complain was available and easy to understand.

• Patients said they found it easy to make an appointment 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.

We saw areas of outstanding practice, including:

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. The nurse practitioner or GPs carried out weekly ward rounds at a residential home. Outcomes showed 61% reduction in unplanned hospital admissions and improved communication with staff at the practice and nursing homes.

The areas where the provider should make improvement are:

• We noted two nursing rooms were carpeted. This had not been risk assessed as part of the infection control audit.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 August 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.
• Longer appointments and home visits were available when needed.
• Where appropriate patients with more than one long-term condition were able to access a joint review to prevent them having to make multiple appointments.
• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For patients with complex needs, a named GP and practice nurse worked with relevant community and healthcare professionals to deliver multidisciplinary support and care. Multidisciplinary meetings were held to review patients’ needs and to avoid hospital admissions.
• Patients with COPD and Asthma had self-management plans and access to medication at home for acute exacerbations and were directed to a structured education programme.
• The pharmacist carried out medication reviews for patients and provided face to face consultation should patients have any medication queries.

Updated 24 August 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.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw good examples of joint working with midwives and health visitors. A midwife held antenatal clinics weekly.
• A contraceptive service including the fitting of contraceptive coils and implants was available for patients.

Updated 24 August 2016

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

• The practice offered proactive, personalised care to meet the needs of the older people in its population. Patients wherever possible were booked appointments with their named GP to ensure continuity of care. Evidence from the practice showed continuity of care had improved as a result.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. The nurse practitioner or GPs carried out weekly ward rounds at a residential home. Outcomes showed 61% reduction in unplanned hospital admissions and improved communication with staff at the practice and nursing homes.
• The practice carried out an annual audit of those patients over 65 years old, and those who had not had contact with the practice, contact would be made to identify if they needed any support and to check on their well-being.
• Learning from the positive outcomes of the Hyde Healthy Living project and working with the CCG the practice had recently employed a Well-being co-ordinator to support patients and their carers over 75 years old. Working with patients to create holistic care plans and liaise with local health and social care providers and voluntary organisations.
• The practice employed a pharmacist who carried out medication reviews and reviewed all medication following hospital admissions.
• The practice embraced the Gold Standards framework for end of life care. This included supporting patients’ choice to receive end of life care at home.

Updated 24 August 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.
• Appointments were available outside of normal working hours, with one evening surgery.
• 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.
• To improve access and reduce the number of patients having to make appointments via the telephone. The practice promoted online access by releasing 80% of on the day appointments at midnight allowing patients to book next day appointments and pre bookable appointments up to two weeks in advance.

Updated 24 August 2016

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

• 89% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months.
• 92% of patients with poor mental health had a comprehensive care plan documented in the record agreed between individuals, their family and/or carers as appropriate.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• It carried out advance care planning for patients with dementia.
• The practice had told patients experiencing poor mental health how to access various support groups and voluntary organisations. The practice promoted self-referral to the local “Healthy Minds” service.
• A free in-house counselling service was available for patients; this was provided by counsellors completing counselling training and were supervised by the university they were studying.
• Self Help Resources to Improve Mental Wellbeing, with a free download available via the practice website which included links to internet sites such as ‘moodgym’, and contact details for local and national support organisations and self-help books.
• Staff actively followed up patients who were known to have suffered a crisis and offered an appointment with a GP.
• It had a system in place to follow up patients who may have been experiencing poor mental health and had attended accident and emergency.
• Staff had a good understanding of how to support people with mental health needs and dementia.

Updated 24 August 2016