Archwood Medical Practice

Updated 1 July 2016

Archwood Medical Practice is part of the NHS Stockport Clinical Commissioning Group (CCG). Services are provided under a personal medical service (PMS) contract with NHS England. The practice is a partnership between two GPs. The practice has 6140 patients on their register.

Information published by Public Health England rates the level of deprivation within the practice population group as six on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. The average male life expectancy in the practice geographical area is 79 years and is reflective of both the England and CCG averages. Female life expectancy is 82 years which is below the CCG and England average of 83 years.

The GP partners (one male and one female) are supported by two female salaried GPs. The practice employs a practice manager, a business manager, three part time practice nurses, two part time health care assistants as well as reception and admin staff.

The practice reception is open from 8am until 6.30pm Monday to Fridays with late night appointments available until 7.30pm on Mondays and Tuesdays and early morning appointments from 7.30am on Fridays.

When the practice is closed patients are asked to contact NHS 111 for Out of Hours GP care.

The practice provides online access that allows patients to order prescriptions.

The practice building is a modern building maintained by NHS Property Services. The practice is located on the first floor. There are also three other GP practices located on the first floor. Patients can access the first floor via the passenger lift. A hearing loop to assist people with hearing impairment is available, although this was waiting on a repair. Limited car parking was available at the practice.

Updated 1 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Archwood Medical Practice on 15 June 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 a system in place for reporting, recording and responding to 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 were complimentary about the quality of service they received but some said that they found it difficult getting through to the practice by telephone. The practice was aware of this, and had been in consultation with the Clinical Commissioning Group (CCG) for a lengthy period of time. The practice had just received confirmation that a new call routing telephone system was going to be installed.
• Patients told us they usually got an appointment quickly. The practice also offered a GP call back service. Urgent appointments were available the same day.

• 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. The provider was aware of and complied with the requirements of the duty of candour
• 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 practice business plan was comprehensive and this was supported with action plans to improve and develop the service provided. This included improving team support systems with more team meetings and staff appraisal.

We saw one area of outstanding practice:

• Systems to monitor, track and risk assess the progress of most aspects of service delivery were recorded on spreadsheet ‘trackers’. These enabled staff to quickly identify progress in mitigating risks, achieving specific targets and responding to shortfalls in service delivery to the benefit of patients. Examples included: the monitoring of two week referrals to secondary care to ensure they were responded to and the monitoring of patients discharged from hospital who had a practice care plan in place so that telephone checks could be made to the patients to offer additional support if required.

The areas where the provider should make improvement are:

• Implement the planned programme of weekly clinical meetings.
• Implement the planned programme of staff appraisal.
• Continue to recruit patients to the patient reference group and consult with them as planned.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 1 July 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’s performance was comparable to the Clinical Commissioning Group (CCG) and the England average in four out of five of the diabetes indicators outlined in the Quality and Outcomes Framework (QOF) for 2014-2015. The practice had recruited a practice nurse with diabetes training and this had improved the practice’s record of diabetic foot checks.
• 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 1 July 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 comparable to the CCG 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.
• Data showed that the practice performed similarly to the CCG and England average for the percentage of women aged 25-64 who had received a cervical screening test in the preceding five years with 81% compared to 82% for the respective benchmarks.
• We heard about positive examples of joint working with district nurses and health visitors.

Updated 1 July 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. For example a practice nurse visited housebound and vulnerable patients at home to review their needs and agree a care plan.
• Twice weekly visits were undertaken to a care home to review all the patients registered with them.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• Bi-monthly palliative care meeting were held and community health care professionals attended these.

Updated 1 July 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 offered early morning appointments from 7.30am one morning per week and late night appointments twice a week until 7.30pm.
• 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 1 July 2016

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

• Data from 2014-15 showed that 83% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was similar to England average of 84%.
• 100% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan recorded in the preceding 12 months which was above the England average of 90% (2014-15 data).
• 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 where they may have been experiencing poor mental health. 

Updated 1 July 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 those with a learning disability.
• The practice offered longer appointments for patients who were vulnerable or 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.