Coppull Medical Practice

Updated 6 September 2016

Coppull Medical Practice is located in Coppull, Chorley, Lancashire. The practice is located in a surgery which also houses a pharmacy. There is easy access to the building and disabled facilities are provided. There is a small car park next to the practice. Primary medical services are provided under a General Medical Services (GMS) contract with NHS England and the practice is part of the Chorley with South Ribble Clinical Commissioning Group.

There are five GPs working at the practice. Four GPs are partners, three male and one female and one female GP is salaried. There are one full time practice nurse and one part time practice nurse and one part time health care assistant (all female). There is a full time practice manager and a team of administrative staff.

The practice opening times are Monday, Wednesday and Friday 8 am to 12.30pm and 1.30 to 6.30pm, Tuesday 8am to 6.30pm, Thursday 8am to 1pm. The practice appointment times are;

Monday: 8.30am to 12.30pm and 1.30pm to 6pm

Tuesday: 8.30am to 12.30 and 1.30pm to 6pm

Wednesday: 8.30am to 12.30pm and 1.30pm to 6pm

Thursday: 8.30am to 1pm

Friday: 8.30am to 12.30pm and 1.30pm to 6pm

Patients requiring a GP outside of normal working hours are advised to call the 111 service who will provide a telephone assessment and if an out of hours GP is required they will pass the patients details to Chorley Medics.

There are 7907 patients on the practice list. The majority of patients are white British with a high number of elderly patients and patients with chronic disease prevalence.

Updated 6 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Coppull Medical Practice on 30 March 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.

• 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.

• Thorough recruitment procedures were carried out before staff were employed.

• Patients said they found it easy to make an appointment with a named GP 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.

• The provider was aware of and complied with the requirements of the Duty of Candour.

The areas where the provider should consider making improvements :

• Consider developing “Easy to read” information for those who require it.

• Produce a quality assurance policy and procedure to act as an overarching framework for continuous quality improvement

The area where the provider was displaying outstanding practise was:-

The practice had corresponded regularly with hospital consultants,other healthcare providers, NHS England and the CCG to try to improve services for patients. This had been recognised by the Clinical Commissioning Group (CCG) establishing monthly meetings with the practice to identify and resolve issues. Detailed minutes recorded actions agreed with an update on progress at the next meeting.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 6 September 2016

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

• The practice had a robust chronic disease programme which included:

• Robust annual review call and recall programme, with a dedicated staff member running the programme.

• Annual review with a clinician for all chronic disease patients.

• Comprehensive information leaflet regarding what to expect at annual review sent with all first invites.

• A Practice nurse dedicated to chronic disease review, with special interest in diabetes.

• Annual medication reviewed for all patients on repeat medication, with robust procedures for non-compliant patients.

• Longer appointments offered for patients with multiple conditions.

• Home visits carried out by a practice nurse for house bound patients with chronic disease.

• A Warfarin clinicheld weekly run by the practice nurse. The practice provided evidence of a 100% satisfaction rating from patients attending this clinic.

• The practice offered diabetic foot screening call and recall

• CQC data indicated that the practice achieved 100% for figures relating to diabetes.

• 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.

• Post-hospital discharge care plan reviews were carried out with patients who attended A&E unnecessarily.

• Pre-diabetes monitoring and NHS health checks were carried out to identify patients who may potentially be at risk of developing a long-term chronic condition.

Updated 6 September 2016

The practice was rated as good for the care of families, children and young people.

• The practice had high achievement with their childhood immunisation programme achieving up to 100% uptake in 2014/15.

• There were systems in place to identify non- attenders for immunisations. These were discussed with the safeguarding lead and the health visitor.

• There was a dedicated childhood immunisation and development check clinic. Patients were able to also book in to the treatment room if they needed to attend after school.

• The practice had links to the health visitor who was informed of all children who have joined or left the practice.

• There were safeguarding procedures in place for children who were vulnerable. All staff and GPs received regular safeguarding training.

• Childhood flu immunisations were offered, with flu clinics on Saturdays to allow school age children to receive their vaccines at the weekend.

• There was a weekly midwifery clinic.

• Vaccine programmes were aimed at students and young people (MMR, Men C).

• The practice offered a private room for breastfeeding and there were baby changing facilities.

• There was a programme for flu and whooping cough vaccinations in pregnant women.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and younger patients who had a high number of A&E attendances.

• 79% of patients with asthma, on the practice register,had an asthma review in the preceding 12 months that included an assessment of asthma control using the 3 RCP questions. This compared to a national average of 58.72%.

• 86.58% of women aged 25-64 are recorded as having had a cervical screening test in the preceding 5 years.This compared to a national average of81.83%.

• There was a dedicated child & adult safeguarding lead.Safeguarding training had been provided to practice staff.

Updated 6 September 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 patients.
• The practice offered home visits and urgent appointments for those with enhanced needs.
• Care plans and health checks were provided as needed with regular medicine reviews carried out.
• The building was accessible for patients who may have mobility problems.

• The practice established a nursing home programme supporting three homes in the locality. The practice nurse visited the homes monthly to ensure patients chronic disease needs were met, identifying training needs for nursing home staff and supporting them in managing chronic disease. The service had been audited and found to have been successful in improving care for patients, improving knowledge for nursing home staff and saving NHS prescribing costs.
• The practice offered flu, pneumonia and shingles vaccination programmes.
• Dementia screening was offered in chronic disease clinics.
• The Practice nurse had dedicated time (approx. 6 hrs per week) to deliver care in the community to elderly and vulnerable patients. She provided a care plan programme and was proactive with identifying social care needs and assessing safeguarding concerns.

• Referrals to other services were regularly made, for example the falls service and dietetic service.

Updated 6 September 2016

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

• The practice had a flexible appointment system for the treatment room clinic
• Patients could book routine appointments up to 6 weeks in advance online.
• Flu clinics were held on Saturday to allow working people to attend at the weekend.
• The practice promoted online services and text messaging to make it easier for patients who worked to access services outside of practice hours.
• The practice had purchased cholesterol and glucose meters to allow patients who work to be able to have their NHS health check in the afternoon, without the requirement to attend for a blood test in the morning.

Repeat prescriptions were left in the onsite pharmacy at evenings and weekend, so patients who work could collect their prescription up to 10pm at night and all weekend

Updated 6 September 2016

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

• The practice nurse was pro-active in identifying patients with memory problems at their annual review and referring them for memory assessment.
• The practice had a dedicated area in the waiting room with information regarding dementia and carer information, with a leaflet developed by the practice, dedicated informing carers regarding services and support.
• The practice nurse provided carers of patients with dementia with information regarding dementia and caring for a person with dementia.
• All patients newly diagnosed with dementia were invited for an enhanced dementia review with the practice nurse. This included health screening, social assessment, discussion regarding future care planning, legal issues and carer assessment.
• Carers of patients with dementia were invited for a carers’ health check and social assessment.
• The GPs had been working with the CCG and mental health consultants for several years to identify issues with the current service provision and improvements that can be made. This was due to patients and GPs feeling the current service did not always meet the patients’ needs.

• 97.5% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record, in the preceding 12 months.This compares to a national average of 88.47%.

• 87.34 % of patients diagnosed with dementia had their care reviewed in a face-to-face review in the preceding 12 months. This compared to a national average of 84.01%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

Updated 6 September 2016

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

• Patients with a learning disability or other significant disability had an alert on their medical record, this allowed all staff to quickly identify when dealing with a patient that they may require additional assistance.
• The practice had a register of vulnerable adults and children and a review of these patients was undertaken every 3 months to identify any concerns that required further action.
• A patient health form had been introduced with a section for patients to record if they had a disability, medical condition or are a carer. These were passed to the practice manager who ensured this was clearly noted on the record and contacted the patient to discuss their needs if indicated.

• The practice had posters and leaflets informing patients with a disability that they could discuss their individual needs with the practice manager if required.

• Both non clinical and clinical staff were trained in the mental capacity act. There were procedures in place for identifying patients with a DOLS(Deprivation of Liberty Safeguard) in place.

• The practice regularly worked with multi-disciplinary teams in the case management of patients deemed to be vulnerable.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.