Cheadle Medical Practice

Updated 22 August 2016

Cheadle Medical Practice is part of the NHS Stockport Clinical Commissioning Group (CCG). Services are provided under a general medical service (GMS) contract with NHS England. The practice is a partnership between four GPs. The practice has 11804 patients on their register.

Information published by Public Health England rates the level of deprivation within the practice population group as seven on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. Both male and female life expectancy at 80 years and 84 years respectively is above both the CCG and England average of 79 years (male) and 83 years (female).

The GP partners (three male and one female) are supported by three female salaried GPs. The practice employs a general manager, an assistant general manager, a reception manager, three practice nurses, including one advanced nurse practitioner, one pharmacist, four health care assistants as well as reception and admin staff.

The practice is training practice for qualified doctors who are training to be a GP. Two of the GP partners are trainers. The practice also accepts undergraduate medical students for teaching.

The practice reception is open from 8am until 8pm Monday and Thursdays with late night appointments available until 7.40pm. On Tuesdays early morning appointments are available from 7.30am and on Wednesdays and Fridays the practice is open from 8am until 6.30pm. The practice opens two Saturday mornings per month to see patients who have made a pre-bookable appointment.

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 book appointments and order prescriptions. The practice advertise a mobile telephone number patients can use to cancel appointments.

Cheadle Medical Practice is situated in a row of four Georgian houses. There is an independent pharmacy in the ground floor extension. There are 12 consulting rooms - two of which are equipped for procedures including minor ops and intrauterine device (IUD) insertions.

Facilities to support people with disabilities are available. These include a passenger lift, an adapted toilet and hearing loop.

Updated 22 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cheadle Medical Practice on 30 June 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with staff and stakeholders and was regularly reviewed and discussed with staff.
• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• 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. The practice had a strong commitment to supporting staff training and development.
• Feedback from patients about their care was consistently and strongly positive. Patients described the GPs and staff as caring and professional.
• 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 received confirmation that in September 2016 that a new call routing telephone system was going to be installed.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure they met people’s needs.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group. For example the practice had reviewed it patient appointment access and adapted their appointment system to improve access.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice actively reviewed complaints and how they are managed and responded to, and made improvements as a result.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.

We saw some areas of outstanding practice:

• A comprehensive spreadsheet tracking all patients designated at risk or with a safeguarding protection plan in place was maintained. This provided the safeguarding lead with quick access to the patients’ past history and assisted monitoring of patients attending emergency departments.
• One GP had developed an easy read protocol for clinicians to follow should there be suspicion of infection or questions around the Zika virus. This had been shared and adopted by the CCG, the local public health team and by Public Health England in Manchester. The GP had also developed templates for use with the patient clinical record system which had also been shared by the CCG with other practices. These included the child immunisation, cardiovascular and flu.
• The practice was active in using national media to raise awareness about different health campaigns. For example the GP practice had recently featured on the local news programme Northwest Tonight to promote the uptake of the flu vaccine for adults and children. This had resulted in an increase uptake of the flu vaccine.
• The GP who was also the clinical lead for the CCG was actively involved and promoted (through online videos) Stockport Together, an initiative working with the local council, GP practices, NHS hospitals for acute medicine and mental health and the voluntary sector to look at ways to bring together health and social care services to provide a more responsive service to patients and people living in Stockport.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 August 2016

The practice is rated as good for the care of people with long-term conditions.

• GPs were allocated a clinical lead role for chronic disease management, and they were supported by the practice nurses. Patients at risk of hospital admission were identified as a priority.

• The practice performed better than the national average in all five of the diabetes indicators outlined in the Quality of Outcomes Framework (QOF).

• Longer appointments and home visits were available when needed.

• Patients were referred to community support and education initiatives such as Xpert patient, Stockport Wellbeing group and Walk for health.

• 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 22 August 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 or better than 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 better than 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 93% compared to 82% for the respective benchmarks.

• The practice referred young patients to the community paediatric team when needed.

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

Updated 22 August 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 to a local care home were undertaken by the same GP to promote continuity of care.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• Monthly Gold Standard Framework (GSF) or palliative care meetings were held and community health care professionals attended these. GSF is a systematic, evidence based approach to optimising care for all patients approaching the end of life.

• The practice had an Age UK link worker to refer patients to, when additional support was required.

• The practice sent all patients a voluntary questionnaire on their 75th birthday to identify any health care issues. This enabled the practice to offer additional medical support if required.

Updated 22 August 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 7.40pm, with GPs, practice nurses and healthcare assistants. In addition Saturday morning surgeries were held twice a month.

• 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 22 August 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 90% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was above the Clinical Commissioning Group average of 87% and the England average of 84%.

• 89% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan recorded in the preceding 12 months which reflected local and the England average.

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

• Patients with a diagnosis of dementia had twice yearly reviews and staff had received dementia awareness training.

• 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 22 August 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.

• One GP visited a care home for people with a learning disability and complex health needs to ensure continuity of care.

• 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.