Archived: Harrowside Medical Centre

Updated 18 August 2016

Harrowside Medical Centre is housed on the ground floor of the modern, purpose built South Shore Primary Care Centre in the South Shore area of Blackpool.

There is onsite parking available and the practice is close to public transport. The practice provides services to 4557 patients.

The practice is part of the NHS Blackpool Clinical Commissioning Group (CCG) and services are provided under a Personal Medical Services Contract (PMS).

There are two male and one female GP partners. The practice also employs three practice nurses, a health care assistant and a clinical pharmacist. The non-clinical team consists of a practice manager and 12 administrative and reception staff who support the practice.

The practice is open between 8am and 7.45pm on Monday, 8am and 7.30pm on Tuesday and 8am and 6.30pm on Wednesday to Friday. 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.

The practice has a larger proportion of patients aged over 45 years of age compared to the national average and 27% of the practice population are aged over 65 years of age compared to the national average of 17%.

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.

The practice caters for a larger proportion of patients experiencing a long-standing health condition (62% compared to the national average of 54%) than average practices. The proportion of patients who are in paid work or full time education is lower (42%) than the CCG average of 52% and the national average of 62% and unemployment figures are higher, 11% compared to the CCG average of 7% and the national average of 5%.

The practice provides level access for patients to the building with automated entry doors and is adapted to assist people with mobility problems. The building has three floors, and the practice reception, consulting and treatment rooms are all on the ground floor.

There is a long walk inside the building to the practice and there is a wheelchair at the main entrance reception to assist those who need it.

Updated 18 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Harrowside Medical Centre on 5 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. Actions taken were reviewed to ensure that they had been implemented and were effective.
• 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.

We saw several areas of outstanding practice:

• We saw many examples of a caring practice. For example, we saw evidence of care for a terminally ill patient where the practice had planned GP home visits to the patient with a specialist from the hospital at the same time. We saw a letter from the patient’s relatives praising the care received and a letter from the specialist recognising the benefit to the patient that this joint working had provided.
• Staff at the practice engaged with local and national charitable services and supported local health organisations including the local hospice in raising funds for them.

• The practice had shared clinical learning with the community district nursing team. Staff in the practice had been trained by the district nurses in specialised diagnostic assessment of patients and in patient wound dressings. In return, the practice staff assisted in the training of district nurses in the management of chronic disease.
• The practice sought opportunities for early identification of illnesses so as to prevent complications and treat appropriately. For instance, they assessed all patients attending clinics for influenza vaccinations for signs of atrial fibrillation (a heart condition).

The areas where the provider should make improvement are:

• The practice should minimise the risks that may be associated with the security of blank prescription pads.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 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.
• 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.
• The practice worked with the community district nurses to develop new skills in the management of patients. The practice assisted in the training of district nurses in the management of chronic disease.
• The practice sought opportunities for early identification of illnesses so as to prevent complications and treat appropriately. For instance, they assessed all patients attending clinics for influenza vaccinations for signs of atrial fibrillation (a heart condition).

Updated 18 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.
• Childhood immunisation rates for the vaccinations given were better than the CCG averages. Of the ten vaccinations given to five year olds, eight of them achieved 100% with the other two being 95% (CCG averages were 87% to 97%).
• 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 74% which was lower than the CCG average of 81% and the national average of 82%. The practice had recognised that these figures were low and sent personalised letters to patients who did not attend.
• 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, school nurses and hospital specialists.
• The practice provided its own information leaflets for young people regarding patient confidentiality and contraception.

Updated 18 August 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.
• A national charitable organisation visited the practice every week to provide advice on patient social care.
• The practice had a prescription clerk available each morning by telephone to arrange repeat prescriptions for elderly or housebound patients who were experiencing difficulties.
• Because the practice was situated some distance from the front entrance of the building, there was a wheelchair for patients at the front entrance for patient use. This was advertised to patients in the waiting area.

• There were chairs in the corridors for patients who experienced difficulties in walking a long distance and staff knew when patients would be waiting there.

Updated 18 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.
• 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.

• The practice offered a ‘Commuter’s Clinic’ on a Monday evening until 7.45pm and on Tuesday evening until 7.30pm for working patients who could not attend during normal opening hours.

• From the national GP patient survey, 97% of patients were satisfied with the practice’s opening hours compared to the national average of 78%.

Updated 18 August 2016

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

• 90% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is better than the national average than the national average of 84%.
• 94% of people experiencing poor mental health had a comprehensive, agreed care plan documented in the record compared to the national average of 88%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients 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. Staff had received training on dementia awareness.

Updated 18 August 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 children at risk 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.

• There were disabled facilities, a hearing loop and translation services available. Translation services were also available on the practice website.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff we spoke to showed a thorough understanding of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.