Levenshulme Medical Practice

Updated 1 April 2016

Levenshulme Medical Practice is based in Manchester and is part of the NHS Central Manchester Clinical Commissioning Group (CCG) and has 7220 patients. The practice provides services under a General Medical Services contract with NHS England.

Information published by Public Health England rates the level of deprivation within the practice population group as two on a scale of one to 10. Level one represents the highest levels of deprivation and level 10 the lowest. Male and female life expectancy in the practice geographical area is 75 years for males and 82 years for females, both of which are slightly below the England average of 79 years and 83 years respectively. The numbers of patients in the different age groups on the GP practice register were generally similar to the average GP practice in England. There is a higher number of patients from 25 to 39 years of age than the national average.

The practice has a lower percentage (59.3%) of its population with a working status of being in paid work or full-time education (2014/15) than the England average (61.5%). The practicehas a higher percentage (9.3) of its population with a status of being unemployed than the England average (5.4%).

The practice is based in a purpose built building with access for people with mobility problems. The practice has a number of consulting and treatment rooms used by the GPs and nursing staff as well as visiting professionals such as health visitors.

There are five GP partners, a practice manager, an assistant practice manager, two nurses and a healthcare assistant as well as a number of reception / administrative staff who also cover other duties such as dealing with samples and drafting prescriptions.

The practice is open Mondays to Fridays from 8am to 6pm with late appointments on Tuesday and Thursday evenings until 7:30pm. In addition to pre-bookable appointments that can be booked up to four weeks in advance, urgent appointments are also available for people that need them such as young children or the elderly. Online appointments, home visits and telephone consultation services are also available. Out of hours cover is provided by the “Go-to-Doc” service as well as the NHS 111 service.

Updated 1 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection on 25 February 2016 at Levenshulme Medical Practice. 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 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.
• 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 provider was aware of and complied with the requirements of the Duty of Candour.
• The practice was working with other local practices and the community nursing team to actively support and manage people living in care and nursing homes to avoid unplanned admissions into hospital.

Areas of outstanding practice:

• One GP had taken a proactive lead in the area of promoting health strategies to local and national ethnic communities. Programmes such as promoting Hepatitis C awareness, breast screening, domestic abuse and health checks were being proactively delivered to the local Asian community. The practice were collaborating with local women’s groups, health centres and places of worship to promote better local health.

The areas where the provider should make improvements are:

• Undertake a review of risks with appropriate mitigating actions for those identified in relation to lone working and the carrying of blood samples.
• Ensure the practice business strategy is up to date and fit for purpose.
• Ensure there is a system to monitor and audit the traceability of the prescription paper used in the practice.

Promote the patient participation group (PPG) to be actively involved and to ensure feedback is acted upon from all sources such as the national GP survey.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 1 April 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 below the national average for two of the five indicators:
  • 93.49% of patients with diabetes had received an influenza immunisation compared to the national average of 94.45%.
  • A record of foot examination was present for 91.9% compared to the national average of 88.3%.
  • Patients with diabetes in whom the last blood pressure reading (measured in the preceding 12 months) was 140/80 mmHg or less was 87.3% compared to the national average of 78.03%.
  • Patients with diabetes whose last measured total cholesterol (measured within the preceding 12 months) was 5 mmol/l or less was 82.34% compared to the national average of 80.53%.
  • The percentage of patients with diabetes, on the register, in whom the last IFCCHbA1c is 64 mmol/mol or less in the preceding 12 months was 74.94% compared to the national average of 77.54%.
• 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.

Updated 1 April 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.
• The percentage of patients with asthma, on the register, who had an asthma review in the preceding 12 months that included an assessment of asthma control using the 3 RCP questions (01/04/2014 to 31/03/2015) was 71.72% which was below the national average of 75.35%.
• 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 69.8%% (March 2015), which was above the CCG average of 65.4% but below the national average of 74.3%.
• 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 April 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.

Updated 1 April 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.

Updated 1 April 2016

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

• 80.65% of patients diagnosed with dementia who had had their care reviewed in a face to face meeting in the last 12 months, which is below the national average of 84.01%.
• 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 was 90.14% compared to the national average of 88.47%.
• The percentage of patients diagnosed with dementia whose care had been reviewed face to face in the preceding 12 months was 80.65% compared to the national average of 84.01%.
• The practice regularly worked with multi-disciplinary teams in the case management of people 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 1 April 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 multi-disciplinary teams in the case management of vulnerable people.
• 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.