Archived: Chorley Health Centre

Updated 17 September 2015

Chorley Health Centre also know as Dr Carlos Irizar practice is situated in Chorley Lancashire. It is part of the NHS Chorley and South Ribble Clinical Commissioning Group (CCG.) Services are provided under a general medical service (GMS) contract with NHS England. There are 4000 registered patients. The practice is situated on a residential road with limited parking available. Information published by Public Health England, rates the level of deprivation within the practice population group as five on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. Deprivation affecting children with in the practice is rated at 17% compared with CCG averages of 13.2%; deprivation affecting older people is rated at 21% compared with CCG averages of 17%. These results are below the national averages of 21.8% for children and above for older people at 18.1% nationally.

The practice population includes a lower number (26.1%) of people over the age of 65, and a higher number (31.7%) of people under the age of 18, in comparison with the national average of 26.9% and 31.9% respectively. The practice also has a higher percentage of patients who have caring responsibilities (23%) than both the national England average (18.4%) and the CCG average (21.6%). The practice has a high rate of patients with health-related problems in daily life (56.7%) compared with CCG and National averages of 50.3% and 48.7%.

The practice telephone lines open from 8.00 am to 6.30pm Monday to Friday. Appointments are available during these opening times with the GPs and appointments with the nurse are available daily until 6pm except Friday when she finishes as 1pm. They hold seasonal Flu vaccination clinics at certain times of the year. Patients requiring a GP outside of normal working hours are advised to contact an external out of hour’s at Chorley Medics based Euxton Lancashire.

The practice has recently experienced a difficult period with changes to its registration with the Care Quality Commission and to clinical and administrative staff. Dr Carlos has has intrpduced a new team to provide care for the patients. This transition period has not been without incident and the practice has managed to maintain their commitment to both the patients and staff in a professional manner.

On-line services include appointment booking and ordering repeat prescriptions and access to medical records. The patients made good use of the electronic prescription service.

The practice has a virtual patient participation group who receive regular information form by email from the practice and are asked for their views on any changes.

Updated 17 September 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Chorley Health Centre Dr Carlos Irizar Practice on 26/08/2015. Overall the practice is rated as good.

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

• 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.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• 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.
• 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.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should

• Ensure recruitment procedures include all necessary employment checks for all staff including staff promoted internally

• Ensure all patients undergoing minor surgery have their written consent forms scanned onto the electronic patient records

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 September 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 GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 17 September 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 in line with the Clinical Commissioning Group averages 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 examples of joint working with midwives.

Updated 17 September 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. The practice was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 17 September 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 17 September 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). 100% of people experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those 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 (A&E) where they may have been experiencing poor mental health. Staff training on how to care for people with mental health needs and dementia was planned.

Updated 17 September 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 carers and those with a learning disability. The practice had carried out annual health checks for people with a learning disability and 95% of these patients had received a follow-up. 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. The practice 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.