The Maples Medical Centre

Updated 17 January 2017

The Maples Medical Centre, 2 Scout Drive, Newall Green, Manchester is registered to provide services from a branch surgery located at: The Lakes, 53c Mainwood Road, Timperley WA15 7JW.

It provides primary care services to 8165 patients under a General Medical Services (GMS) contract. The Maples Medical Centre is situated in a purpose built property in a residential area of Wythenshawe, Manchester. There is onsite parking available and good access to local transport links.

The practice has four GP partners (one male and three female). The clinical team includes two advanced nurse practitioners, two practice nurses and two health care assistants, all of whom are female. The practice management and administration team consists of a practice administrator, two secretaries and 10 receptionists.

The practice supported medical students and qualified doctors who wished to become GPs.

The practice population demographic shows there is a lower than average patient population aged between 60 to 85 years and higher than average patient population aged between 20 to 40 years compared with local and national averages.

Information published by Public Health England rates the level of deprivation within the practice population group as one on a scale of one to 10. Level one represents the highest levels of deprivation and level 10 the lowest.

Average male and female life expectancy for the practice is 75 years (m) and 79 years (f), which is similar to the national average of 79 and 83 respectively.

The practice is open from 8.30am to 6.30pm Monday to Friday with the telephone lines opening at 8am. The practice phone lines are diverted to the out of hour’s service on a Thursday afternoon although the practice remains open for appointments.

When the practice is closed patients have access to GotoDoc the local out of hours provider. Alternatively patients can access urgent care by contacting the NHS 111 service.

Updated 17 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Maples Medical Centre, 2 Scout drive, Newall Green, Manchester, M23 2SY on 14 November 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 been trained to provide them with 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and 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.

We saw several areas of outstanding practice:

The practice had a focus on social inititives to improve social isolation for vulnerable patients. They supported community services such as, the NewLife opportunities centre. The centre offered access to sports pitches, a recording studio, and a hall for events and dancing for the people of Wythenshawe. The practice also hosted the weekly Brush & Brew sessions which were held at the branch practice (The Lakes). GPs were able to refer patients to Brush & Brew which is a therapy programme aimed at promoting wellbeing for patients in the area.

The practice launched the local TimeBank service and there was a weekly meeting held at The Maples. This meeting was open to patients and members of the local community. TimeBank provided a mentoring service and worked with businesses to engage their staff in volunteering to support vulnerable patients and people in the community.

The practice was working closely with staff from Healthy Manchester who liaised with the practice on a quarterly basis. GPs made referrals to this eight week telephone based service. The service helped patients to manage their condition and where possible supported them back into employment. Data provided by the practice and Healthy Manchester showed The Maples had referred 55 patients which was the highest referral rate in Greater Manchester.

One of the GPs held teaching a recent teaching session at a local dementia care service on basic observations such as; urine dip testing. This assisted staff with identifying and expediting treatment for patients who had urinary tract infections. Since the training staff have contacted the practice with results of a dip test and correctly identified early a patient who required antibiotic treatment.

The areas where the provider should make improvement are:

• Establish an ongoing programme of clinical audit to demonstrate quality improvement relating to the outcomes for patients.

• Obtain a set of paediatric defibrillator pads for useon children.

• Include information about the parliamentary health service ombudsman (PHSO) in final complaint response letters.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 January 2017

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 had begun working with the Primary Care Out-Reach Team (a pilot in South Manchester) aimed at improving outcomes for patients with long term conditions. This work was focussing on patients with diabetes, asthma and chronic obstructive pulmonary disease (COPD).
• Patients with COPD had self-management plans, access to medication at home for acute exacerbations and access to pulmonary rehab.
• The practice had identified 40 additional patients with COPD in the last four months working with the Macmillan cancer improvement partnership (MCIP) project.
• The percentage of patients with diabetes, on the register, in whom the last IFCC-HbA1c was 64 mmol/mol or less in the preceding 12 months was 74% (01/04/2015 to 31/03/2016) which was comparable with the CCG and national average of 77% and 77% respectively.
• The percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) is 140/80 mmHg or less (01/04/2015 to 31/03/2016) was 75% which was comparable to the CCG and national average of 77% 78% respectively.
• Longer appointments and home visits were available when needed.
• All these 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.

Updated 17 January 2017

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.
• The practice had alerts and coding systems in place to identify children and families who were a safeguarding concern or on the safeguarding register.
• 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.
• 92% of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding 5 years (01/04/2015 to 31/03/2016) which was better than the CCG and national average of 83% and 82% respectively.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, health visitors and school nurses.
• The practice website had information for children and families and used social media to engage with younger patients.

Updated 17 January 2017

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.
• The practice carried out osteoporosis risk assessments by actively following up patients with fragility fracture. The practice had conducted an audit regarding bisphosphonate use and osteoporosis. Bisphosphonate is a drug that prevents the loss of bone mass and is used to treat osteoporosis and similar diseases.
• Care plans were developed for patients that included hospital admissions avoidance, advance care plans, dementia and end of life care plans.

Updated 17 January 2017

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 January 2017

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

• 83% of patients diagnosed with dementia that had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average of 84%.
• 63% of patients with schizophrenia, bipolar affective disorder and other psychoses whose alcohol consumption has been recorded in the preceding 12 months (01/04/2015 to 31/03/2016) which was below the CCG and national average of 86% and 90% respectively.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan documented in the record, in the preceding 12 months (01/04/2015 to 31/03/2016) was 91% which was better than the CCG and national average of 87% and 88% respectively.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice carried out advance care planning for patients with dementia.
• The GPs provided support and education to staff at a local assisted living unit for people 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 where they may have been experiencing poor mental health.
• Staff had a good understanding of how to support patients with mental health needs and dementia. Patients presenting at the practice in a distressed condition were seen as a priority.

Updated 17 January 2017

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 patients with a learning disability.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice informed 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.
• Patients who had been identified as carers were offered flu immunisations and health checks to assess their physical and mental health to enable them to continue to provide care.
• The practice launched the local TimeBank service and there was a weekly meeting held at The Maples.
• The practice hosted the weekly Brush & Brew sessions which were held at the branch practice (The Lakes).
• The practice was working closely with staff from Healthy Manchester who visited the practice on a regular basis.