Archived: Urmston Group Practice

Updated 31 March 2015

Urmston Group Practice has provided services to the local community for 75 years and does so under a PMS contract. There are currently two surgeries, one at Church Road and one at Woodsend and the practice population is 11,709 with a slightly higher percentage of females. Approximately 25% of the patients are aged over 60 and 18% are aged below 19. There are three male and four female GPs, a female advanced practitioner and three female nurses. In addition the practice employs approximately 24 reception and administration staff across the two sites.

Regulated activities are provided from both 154-156 Church Road, Urmston and 6 Woodsend Circle, Flixton. Both sites were visited as part of this inspection. The practice has opted out of providing out-of-hours services to their own patients and patients are directed to the out-of-hours service when the surgery is closed.

The practice is preparing to move to new updated premises. Plans to move have been under consideration for a number of years and are finally coming to a head in September 2015. All plans for improvements to the practice such as infection control requirements and the implementation of some policies and procedures have been deferred until the move.

The surgery doors are open at both sites on a Monday to Friday between 8.30am and 6.00pm. At Church Road the doors close half an hour later at 6.30pm. The telephone lines are open from 8.30am until 6.00pm at both sites. Extended opening hours are offered at Church Road on a Monday evening from 6.30pm until 9.30pm. Appointments are pre-bookable up to one month in advance and urgent on-the-day appointments are allocated on a first-come-first-serve basis by telephone in the morning for a morning appointment and in the afternoon for an afternoon appointment.

The CQC intelligent monitoring placed the practice in band 4. The intelligent monitoring tool draws on existing national data sources and includes indicators covering a range of GP practice activity and patient experience including the Quality Outcomes Framework (QOF) and the National Patient Survey. Based on the indicators, each GP practice has been categorised into one of six priority bands, with band six representing the best performance band. This banding is not a judgement on the quality of care being given by the GP practice; this only comes after a CQC inspection has taken place.

Updated 31 March 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Urmston Group Practice on 21 January 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing effective, caring, responsive and well led services. It was also good for providing services for all the population groups. It required improving for providing safe services.

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

• The practice were moving to new updated premises. Plans to move have been under consideration for a number of years and were finally coming to a head in September 2015. All plans for improvements to the practice such as infection control requirements and the implementation of some policies and procedures had been deferred until the move.
• One of the GPs at the practice had been nominated and awarded for ‘Going the Extra Mile’.
• 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, with the exception of some training aspects and the availability of some equipment to deal with emergency situations such as patients with difficulty breathing or fainting.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment and information about services and how to complaint was available and easy to understand. Most patients found access to the service acceptable and the practice were continually reviewing access to see if it could be improved.

The areas where the provider must make improvements are :

• Ensure that all staff are appropriately trained in infection control and ensure infection control issues highlighted in the infection control audit are addressed.

The areas where the provider should make improvements are :

• Ensure that there is equipment available for patients who may present with breathing difficulties or suffer from fainting spells.
• Ensure that all staff are appropriately trained and receive regular updates in safeguarding.
• Ensure recruitment arrangements include all necessary employment checks, such as Disclosure and Barring Service checks (or evidence and reason if it is felt these are not required) for all staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 31 March 2015

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 medication 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 31 March 2015

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, health visitors and school nurses.

Updated 31 March 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 31 March 2015

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 31 March 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). People experiencing poor mental health had received an annual physical health check when required. 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 such as MIND and SANE. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health.

Updated 31 March 2015

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 and those with a learning disability. It had carried out annual health checks for people with a learning disability if requested but did pro-actively offer all learning disability patients an annual health check. The practice did not feel equipped to offer an effective service and had therefore opted out of this enhanced service. 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. 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.