Archived: Barrington Medical Centre Partnership Also known as Barrington Medical Centre

Updated 24 April 2018

Dr B N Macdonald and Partners are the registered providers and provide primary care services to their registered list of 7289 patients. The practice delivers commissioned services under the General Medical Services (GMS) contract and is a member of Trafford Clinical Commissioning Group (CCG). The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.

The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of diagnostic and screening procedures, maternity and midwifery services, family planning, surgical procedures and the treatment of disease, disorder and injury. Regulated activities are delivered to the patient population from the following address:

Barrington Medical Centre 68 Barrington Road Altrincham Cheshire WA14 1JB

The practice is situated in an area at number ten on the deprivation scale (the lower the number, the higher the deprivation with the lowest number being one). People living in less deprived areas tend to have different needs to those living in more deprived areas.

The male life expectancy for the area is 80 years compared with the national average of 79 years. The female life expectancy for the area is 84 years compared with the national average of 83 years.

This is a teaching practice where students from the medical school of Manchester University who are training to be doctors can receive education.

The practice has a website that contains comprehensive information about what they do to support their patient population and provides details about the in-house and online services offered. The website can be found at www.barringtonmedicalcentre.co.uk and requires a review to include up to date information.

Updated 24 April 2018

This practice is rated as Good overall. (Previous inspection 10/02/2015 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students) – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Barrington Medical Centre (Dr B N Macdonald and Partners) on 15 March 2018.

At this inspection we found:

• The practice had clear systems to manage risks so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.

• The practice had an effective programme of continuous clinical and internal audits. The audits demonstrated quality improvements and staff were actively engaged in monitoring and improving patient outcomes as a result.

• The partners encouraged a culture of openness and honesty. The practice had systems for being aware of notifiable safety incidents and sharing the information with staff and ensuring appropriate action was taken.

• Staff involved patients and treated them with compassion, kindness, dignity and respect.

• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

• The practice had virtual patient participation group.

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw an area of outstanding practice:

• The practice offered a considerably enhanced service to identify and manage patients with pre-diabetes and/or gestational diabetes before the condition became enhanced. In-house diabetic clinics were personalised and there was a close working relationship with GPs and nurses to the benefit of the patients.One of the administration staff had a systematic review and recall arrangement and ensured that attendance of appointments was monitored.Appointments were co-ordinated with other chronic diseases to minimise the amount of disruption to patients. The length of appointment ranged from 20 minutes to 80 minutes dependent on the requirements and patients and carers could attend appointments together.In addition a supportive information pack had been pulled together on the initiative of one of the clinicial staff.It contained leaflets about management and control, a range of contact numbers, a six week guide, and magazines sourced from different diabetes support groups.

The areas where the practice should consider improvements are as follows :

• The practice should ensure that all staff who are performing chaperone duties have undergone a Disclosure and Barring Service (DBS) check or risk assessment.

• The practice should endeavour to structure meeting agendas so that items such as significant events, complaints, safeguarding and governance issues are consistently raised for discussion.

• Information on the website was outdated and would benefit from a review. For example the complaints policy mentioned the Healthcare Commission and PCT which no longer exist.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 February 2015

The practice is rated as good for the care of people with long-term conditions. There was a high prevalence (52.7%) of patients with long standing conditions, such as cardiovascular disease, Chronic Obstructive Pulmonary Disease (COPD) and diabetes amongst the patient population. There were named GP leads for each area. Nursing staff had additional training and qualification which enabled them to focus upon specific chronic conditions and appropriately assist in the management of them through a comprehensive schedule of clinics. These patients were recalled using an effective administrative system which ensured they had structured annual reviews to check their health and medication needs were being met. For those with the most complex needs GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care. The practice offered enhanced services to meet the needs of patients with long-term conditions such as avoidance of unplanned admissions to hospital through care planning.

Updated 19 February 2015

The practice is rated as good for the care of families, children and young people. Systems were in place for identifying and following up children who were at risk. For example, children and young people who had a high number of A&E attendances. Immunisation clinics for babies and young children were available on a weekly basis. A range of enhanced services were available such as whooping cough in pregnant women, hepatitis B for new born babies, Measles Mumps and Rubella (MMR) vaccination for young people and contraception services. Appointments were available outside school hours and the premises were suitable for children and babies. Children and young people were treated in an age appropriate way and recognised as individuals.

Updated 19 February 2015

The practice is rated as good for the care of older people. Patients at risk of an unplanned hospital admission had a care plan in place. Nationally reported data showed that 25.7% of the patient population were aged 65 or above this was in line with the national average. The practice had good outcomes for conditions commonly found amongst older people. The practice offered proactive, personalised care to meet the needs of the older patients in its population and had a range of enhanced services, for example, avoidance of unplanned admissions to hospital ( patients at risk of an unplanned hospital admission had a care plan in place) , support for people with dementia, Flu vaccination programmes and a shingles vaccination programme for those aged 70 and above. The practice was responsive to the needs of older people including offering home visits as required.

Updated 19 February 2015

The practice is rated as good for the care of working-age people (including those recently retired and students). The needs of this group had been identified and the practice had adjusted the services it offered to ensure these were accessible. Patients were able to book appointments in extended opening hours on Wednesday and Thursday evenings until 1940. A full range of health promotion and screening which reflects the needs for this age group was available.

Updated 19 February 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Patients within this group received a timely recall for their annual physical health check. The practice worked with multidisciplinary teams in the case management of people experiencing poor mental health. The practice provided an enhanced service with a view to facilitating timely diagnosis and support for people with dementia which they were actively working to improve upon. Staff told us the practice had sign-posted patients experiencing poor mental health to various support groups, and they were proactive in helping patients address issues to improve all aspects of their health

Updated 19 February 2015

The practice is rated outstanding for the care of people whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable circumstances for example those with learning disabilities. The practice had a residential facility for people with learning disabilities within their practice area and supported patients living here. Patients with learning disabilities were offered annual health checks, longer appointment were available if required and recall letters were in pictorial format to aid understanding.

The practice worked with multidisciplinary teams in the case management of vulnerable patients. Staff knew how to recognise the 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 and out of hours.

Patients with conditions which led them to be vulnerable at times of crisis had care plans in place to assists them to be treated in an appropriate setting at a time which addressed their immediate need without the need for assistance from the ambulance service or admissions to A&E. This had led to this group of patients reducing their attendance at A&E and supported a timely management of their immediate condition by staff who were familiar with their circumstances and needs.