The New Hall Lane Practice

Updated 2 March 2017

The New Hall Lane Practice is a four partner GP practice located in central Preston and sits within Greater Preston Clinical Commissioning Group (CCG). The practice is located in a purpose built facility, shared with another GP practice and community based clinicians and services. The building is owned by NHS Property Services. Car parking is available on site and the building is fully accessible to people with limited mobility, wheelchair users and parents with prams/pushchairs. All patient areas for the practice are located at ground floor level. The practice hosts a number of other clinicians to deliver additional services, for example antenatal and post-natal care clinic and a child health immunisation and baby clinic.

The partnership is made up of four partners, three male and one female. The practice partners are supported by two long term locum GPs. The practice is a training practice hosting GP Registrars, one male and one female. The nursing team is led by an Advanced Nurse Practitioner who can prescribe medicines for a wide range of conditions; there are four practice nurses who each take a lead in an area of clinical care. One of these nurses is a Nurse Practitioner who can prescribe in their own field of specialism, for example, respiratory illness.   All services are delivered under a General Medical Services (GMS) contract.

The practice is located in an area of social deprivation, where life expectancy is lower than the national average, with men expected to live to 75 years of age, compared to the national average of 79 years and where women are expected to live to 78 years of age, compared to the national average of 83 years.

The practice is open between 8am and 6.30pm each week day. Patients ringing when the practice is closed will be diverted by phone to the NHS 111 service, who in turn will refer people to the locally appointed out of hours provider, Go to Doc.

Updated 2 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The New Hall Lane Practice on 15 December 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 could make an appointment with a named GP and there was continuity of care, although these appointments may not be available at short notice. We saw urgent appointments 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.
• The provider was aware of and complied with the requirements of the duty of candour.

There were some areas where the practice SHOULD make improvements. The practice should:

• Continue to refer safeguarding queries to safeguarding teams, even though these are flagged up immediately to health visitors and midwives.

• Review levels of phone traffic to the practice to enable implementation of an improved phone system to address problems in this area.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 2 March 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.

• Performance for care interventions with patients with diabetes were in line with local and national averages.

• 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 2 March 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 worked positively with midwives, health visitors to raise any concerns about children quickly. However, this was not always followed up with a referral to safeguarding teams, which would provide a record of these concerns that is shared more widely.

• 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.

• Results for cervical screening interventions were in line with local and national averages. The practice had improved its performance in this area by increasing patient attendance at these appointments.

• 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.

Updated 2 March 2017

The practice is rated as good for the care of older people.

• The practice offered 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 kept a register of patients vulnerable to unplanned hospital admission and care plans were in place for these patients.

• Staff knew they could offer longer appointments to these patients to ensure their health care needs were met. Where appropriate, carers of these patients were encouraged to attend appointments.

Updated 2 March 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.

• Although the practice did not offer extended hours surgeries, clinic times were staggered to provide access to appointments throughout the day.

Updated 2 March 2017

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

• 98% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is above the CCG average of 88% and the national average of 89%.

• 90% of patients with schizophrenia, bipolar disorder and other psychoses had a comprehensive, agreed care plan documented in their record within the past 12 months, compared to the CCG average of 88% and national average of 89%.

• 95% of patients with schizophrenia, bipolar disorder and other psychoses had a record of alcohol consumption recorded in their records within the past 12 months, compared to the CCG average of 88% and 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.

• 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 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.

Updated 2 March 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 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.