Murdishaw Health Centre

Updated 13 April 2017

The practice of Dr Gary O’Hare and Dr Sharon Chapelhow is located in Runcorn, Cheshire, and falls within Halton Clinical Commissioning Group. The premises are purpose built and are used to deliver services to approximately 6,900 patients.

The practice partnership is made up of three partners. The clinical team are supported by a two full time advanced nurse practitioners. All services at the practice are delivered under a Personal Medical Services (PMS) contract.

The practice is open from 8am to 6.30pm on Monday to Friday of each week, with extended early morning surgeries between 7am and 8am on Monday, Tuesday and Friday of each week. These early morning surgeries provide additional 10 minute appointments with a GP, between 7 and 8am. A nurse is also available at these early morning clinics. Throughout the week, the regular surgery appointment times are between 8am and 11.50am and from 2pm to 5.50pm. Patients who require GP services outside of the practice opening hours are diverted to an out of hour’s provider by the NHS 111 service.

The practice hosts a number of other services, such as a musculoskeletal clinic, for treatment of sprains and strains. Health visitors and midwives also hold clinics at the practice. Other community based services are available from the practice, such as the services of a well-being officer and a health engagement officer, who provides a link between social services and GP practices.

Updated 13 April 2017

Letter from the Chief Inspector of General Practice

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Opportunities for learning from internal and external incidents were acted on.

• Risks to patients were assessed and well managed. However, the practice was not operating with its full complement of clinical staff which impacted on patient access to appointments and responsiveness of the practice. Recruitment of a pharmacist for the practice had been agreed but this process had not started. The practice was trying to fill a vacancy for a nurse. Staff interviewed said patient access was the main challenge for the practice.

• The practice used innovative and proactive methods to improve patient outcomes, for example, through its use of CCG sponsored services and health promotion.

• There was a system in place to undertake audits with a focus on improving patient care. The practice identified areas for improvement and monitored this over time to ensure required improvements were achieved and sustained, for example in the area of antibiotic prescribing.

• Patients said they were treated with compassion, dignity and respect. Information was provided to help patients understand the care available to them.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they met people’s needs.

• The practice invited suggestions for improvements and made some changes to the way it delivered services as a consequence of feedback from patients and from the Patient Participation Group (PPG).

• The practice was well equipped to treat patients. Information about how to complain was available and easy to understand.

• The practice had a clear vision which had quality and safety as its top priority. There was a clear leadership structure and staff felt supported by management.

There were also areas where the provider could make improvements. The provider should:

• Make checks on the drainage system from the practice premises to ensure that no remedial works are required.

• Ensure sufficient numbers of suitably qualified staff are deployed to meet the needs of patients.

We saw some areas of outstanding practice relating to families, children and young people.

The practice utilised community based services in innovative ways to help patients take ownership of their health and wellbeing. For example, work with a Health Engagement Officer, who acted as a link between local authority social services departments and the practice, had helped and supported numerous patients.

• Patients experiencing depression and isolation were helped to address triggers or causes of these problems, increasing their levels of confidence, in for example, parenting skills.

• We saw examples of this work which had a more far reaching impact, for example, in addressing low level anti-social behaviour of younger patients, in picking up previously undetected safeguarding issues such as teenage self-harm and increasing attendance of older children at school.

• Engagement with the local area Wellbeing officer had been used to provide a community run garden at the practice. More recently, this garden was used to allow younger children to plant and grow vegetables, providing a source of education that linked to health.   

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 11 February 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.

• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 11 February 2016

The practice is rated as outstanding for the care of families, children and young people.

Practice clinicians were highly supportive of parents of children with complex health needs. GPs worked with specialist hospitals in the North West to ensure these children’s health needs were met and that parents had good access to practice GPs and nursing staff. Parents health needs were also met, ensuring they had the support they needed to meet their caring responsibilities.  We saw that the practice worked well with other organisations to bring services to parents and their children, helping them deal with social issues that impact on health. This had a significant, positive impact for those patients, for example by helping address behavioural issues of older children which increased attendance at school, and helping parents develop the skills necessary to deal with challenging behaviour of older children.

Updated 11 February 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.

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

• The practice GPs worked with staff in local nursing and care homes, to ensure these patients health care needs were met.

Updated 11 February 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 11 February 2016

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

• The practice regularly worked with multi-disciplinary teams in the case management of people 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 about how to access various support groups and voluntary organisations.

• It 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 people with mental health needs and dementia.

Updated 11 February 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.

• It offered longer appointments for people with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• It had told 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 and had followed the path of a safeguarding referral to give them a better understanding of how the information provided is prioritised and dealt with. 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. The practice had two designated administrative staff who followed up these referrals to ensure no vulnerable patient’s referral and details had been missed.