Manor Medical Practice

Updated 3 March 2016

Girlington Health Centre is registered with CQC to provide primary care services which include, access to GP’s, the treatment of disease, disorder or injury, family planning services, surgical procedures, diagnostic and screening procedures and maternity and midwifery services. It provides services for 10,000 patients in Bradford and is part of the NHS Bradford District Clinical Commissioning Group (CCG). The practice has a Personal Medical Services (PMS) contract. This is a contract between general practices and NHS England for delivering services to the local community.

There are similar numbers of male and female patients, with higher numbers of young children accessing the practice then the national average and those in the 25-34 age group. The practice catchment area is classed as a deprived area.

The practice has four GP partners and a business manager who is also a partner. There are two female GP’s and two male GP’s who work at the practice, a management team, a nurse practitioner and health care assistants.

Extended hours surgeries are offered on Saturday until 11am. Patients can book appointments up to two weeks in advance. Out of hours care is provided by Local Care Direct, they can be contacted via the surgery telephone number. A further option is to contact the NHS helpline by dialling 111 or consult NHS Direct online.

Girlington Health Centre and Allerton Health Centre which are part of the Carlton Medical Practice are currently undergoing a merger with Phoenix Medical Practice which is located at Allerton. Many aspects of the two practices have been merged, but there remain a few key actions to do before it is fully completed, namely, the full merging of the clinical systems (which are currently partly shared), the merging of the PMS contracts, and a single CQC registration therefore combining the registration to become a single entity called the ‘Carlton & Phoenix Medical Practice’. The current three locations (Girlington Health Centre, Allerton Health Centre, Phoenix Medical Practice Allerton Health Centre) will be merged into two registered locations (Girlington Health Centre and Allerton Health Centre). There will be one patient list for the two registered locations.

As part of the inspection we visited and inspected all sites and that separate reports have been issued on each of the locations.

Updated 3 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Girlington Health Centre on 2 December 2015. 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. Staff understood their responsibilities to raise concerns and report incidents and near misses.
• Risks to patients were assessed and safely 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.
• Patients said they could book urgent appointments when they needed to and these were 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. We found positive working relationships between the staff.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw areas of outstanding practice:

• The practice had an effective complaints system which was supported by a lead clinician who was the Parliamentary & Health Service Ombudsman representative.

• The practice had developed a ‘Digital (dynamic) Care Plan’ system. This enabled selected patients to self-manage their care and for actionable information and proactive care planning and delivery.

• The practice had participated with the Healthy Hearts campaign and won the General Practice Team of the year award for 2015.

• The practice was a pilot site for NHS England to develop the accessible information standard. This tells organisations how they should ensure that disabled patients receive information in formats that they can understand.

The areas where the provider should make improvement are:

• Remove fabric chairs from clinical rooms and replace with wipeable materials

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 March 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

• The practice held a multi-disciplinary Long Term Conditions clinic weekly

• Outcomes for patients with diabetes were similar to the national average

• 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 medicines 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 3 March 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

• 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 numbers of women attending for cervical screening was in line with national averages.

• Appointments were available outside of school hours and the premises were suitable for children and babies with toys available.

• We saw good examples of joint working with midwives, health visitors and school nurses.

• The practice routinely made early contact with new parents.

• We saw that 22 children were on the child protection register. There were alerts on patient records where there were child protection plans active.

Updated 3 March 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.

• We found easy access for those with poor mobility.

• A large nursing home was located directly opposite the practice and the practice were proactively working with the home to make sure that the residents were supported adequately.

• The practice held Palliative Care Gold Standard meetings involving District Nurses, GP’s and the Macmillan nurse.

Updated 3 March 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 had introduced some 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 text messaging service to remind patients about appointments and consent for this was sought from patients before implementation.

• The practice offered a Saturday surgery from 8am-11am.

Updated 3 March 2016

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

• 49% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months and 69% of people identified as experiencing poor mental health had an agreed care plan in the last 12 months.

• Weekly counselling sessions were offered at the practice via an external resource.

• The practice regularly worked with multi-disciplinary teams in the case management of people 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 may have been experiencing poor mental health, and who had attended accident and emergency.

• Staff had a good understanding of how to support people with mental health needs and dementia.

• 14 Palliative care patients were on the practice register. Palliative care meetings were held every month.

• 92 mental health patients were recorded on the practice register. The practice had set up a service where Matrons visited care homes for proactive management (mainly Schizophrenia).

• 30 patients were on the learning disability register. The community trust attended some of these reviews and provided the practice with accessible information.

Updated 3 March 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 homeless people, travellers and those with a learning disability.

• The practice offered longer appointments for people with a learning disability and annual health checks.

• 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.

• We saw that seven adults were on the adult safeguarding register. There were alerts on patient records where there were active adult protection plans.