Conway Road Medical Practice

Updated 1 June 2016

Conway Road Medical Practice is situated on Conway Road, Sale and is accessible by car and by public transport to nearby Sale railway station and also by tram. There is space to park immediately outside the practice with disabled car parking and it is also possible to park on the streets immediately adjacent to the building. Central Sale has a mixed and transient population including affluent areas, social housing and specialised housing. The area is mixed in deprivation and there are a number of migrant workers whose first language is not English.

The building is owned by NHS Property services and in addition to the GP practice it also hosts Sale Community Services which includes services such as community matrons,

The practice offers services to 8,000 patients under a Personal Medical Services Contract and as well as general medical consultations they also offer a number of specialist clinics and services such as cervical smears, travel advice and immunisations, maternity care, diabetic care, asthma reviews and cryotherapy which is the use of extreme cold to kill or remove cancer cells.

There are three full time GP partners, a full time salaried GP and a part time salaried GP and a proportionate mix of male and female. They provide 36 clinical sessions per week and have separate and specific sessions to undertake administrative requirements. The practice’s long standing nurse has recently left and has been replaced by two part time nurses who are available four days a week. The practice nurses run clinics for long-term health conditions such as asthma or diabetes, minor ailment clinics and carry out cervical smears. The GPs are also able to carry out cervical smears. In addition a health care assistant provides blood pressure checks, health checks and smoking cessation advice

The practice is open Monday to Friday 8am until 6.30pm and closed at weekends. Appointments are available from 8.30am until 6.20pm at scattered times with the different GPs throughout the day to accommodate patient requirements. The practice also provide pre-bookable Saturday morning and evening appointments on request.

Saturday morning appointments with a GP or nurse are also available as part of the CCG-wide scheme for extended hours at a neighbouring practice.

Updated 1 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Conway Road Medical Practice on 12 April 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.
• Lessons were learned, information was shared and action was taken to reduce re-occurrence when incidents were raised. A number of positive incidents were shared during the inspection but these had not been recorded.
• 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. All the patient feedback we received was positive.
• 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 that improvements had been made with the appointment system and they found it easy to make an appointment with a named GP. They said 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 some areas of outstanding practice:

• The practice had made arrangements to attend local schools to educate pupils about how to manage their physical and mental health, advise them about the different services available to them and encourage them to seek help when necessary without concern about confidentiality. The point of this was to educate more young people to manage their health at a younger age and therefore reduce long-term conditions in the future.

• They encouraged and assisted staff to progress in their careers. For example they mentored, supported and paid for a member of staff to progress from a health care assistant to a registered practice nurse.

The areas where the provider should make improvement are:

• A member of the clinical team should have a lead role for infection control and staff in infection control lead roles should receive appropriate training to enable them to carry out that role effectively.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 1 June 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.

• Diabetes indicators in the Care Quality Commission’s Data Pack showed that the practice was performing higher than the national average in all aspects.In one example the percentage of patients with diabetes, on the register, who have had influenza immunisation in the preceding 1 August to 31 March (01/04/2014 to 31/03/2015) was 100% compared to the national average of 94%.

• Longer appointments and home visits were available when needed and patients with multiple long term conditions had priority alerts on the computer system if necessary.

• 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 1 June 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 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 had been adjusted according to demand so that they were available outside of school hours and the premises were suitable for children and babies.

• Data from the Care Quality Commission’s Data Pack showed that the percentage of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding 5 years (01/04/2014 to 31/03/2015) was higher than the national average at 87% compared to 82%.

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

• The practice had initiated liaison with local schools following an awareness session delivered by Trafford Youth Group to the staff. The session had highlighted that many young people were not comfortable accessing general medical services due to a lack of trust and understanding. The practice had now arranged to attend schools in the area to make themselves visible as GPs, show they were caring and trustworthy, raise awareness about health management and encourage young people to access services with confidence and privacy.

Updated 1 June 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.

• All practice staff were dementia friends and one member of the team was a dementia champion. They had not yet utilised this role to the benefit of older patients and recognised this was an area that could be developed further.

• The practice was responsible for patients in the surrounding care homes and visited regularly whenever requested. All patients had care plans which were regularly reviewed.

• Nursing homes and family members were given the GPs’ mobile telephone numbers to utilise for continuity of care during times of ill health or end of life.

Updated 1 June 2016

• 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 reflected the needs for this age group.

• They also offered text messaging reminders and an electronic prescribing service.

• Saturday morning appointments and evening appointments were also available on request at the practice however these were only pre-bookable and were not for emergency. Information about this service was available on the practice website but patients who did not use the website may not have been aware of them. When we pointed this out to the practice they put a sign up for patients’ attention.

• In addition Saturday morning appointments were available with a GP or nurse at a neighbouring practice as part of the CCG-wide scheme for extended hours.

Updated 1 June 2016

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

• Data showed that interventions for patients with mental health conditions were higher than the national average. For example The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record, was 97% compared to the national average of 88%. The percentage of patients in that category whose alcohol consumption had been recorded was 95% compared to the national average of 89%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia and 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 and we saw examples where person-centred care and treatment was offered which maintained positive impact for the patients concerned.

• 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 excellent understanding of how to support patients with mental health needs and dementia. They gave examples where information about specific patients had been shared with all staff so that they understood how to provide care and treatment when these patients presented in crisis.

• The practice had made arrangements to attend local schools to educate pupils about how to manage their physical and mental health, advise them about the different services available to them and encourage them to seek help when necessary without concern about confidentiality. The point of this was to educate more young people to manage their health at a younger age and therefore reduce long-term conditions in the future.

Updated 1 June 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 and had visited patients at a women’s shelter.

• 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 provided examples where they had been personally involved in ensuring the wellbeing of vulnerable patients in times of crisis.

• 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.