Adshall Road Medical Practice

Updated 15 November 2016

Adshall Road 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 has 4977 patients on their register.

Information published by Public Health England rates the level of deprivation within the practice population group as five on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. The average male and female life expectancy in the locality reflects both the CCG and England averages of 79 and 83 years respectively.

The practice surgery was purpose built in 1988 and extended in 2010. The practice provides ground level access suitable for people with mobility issues. There is an onsite carpark.

The practice is a registered partnership between two female and one male GP. However, the male GP partner has left the practice. The CQC has received a notification advising us of this. The practice employs a female salaried GP and regularly employs a male locum GP. The practice employs a practice manager, two practice nurses, two health care assistants as well as reception and admin staff.

The practice reception is open from 8.00am until 6.00pm Monday to Friday. The telephone lines are available until 6.30pm Monday to Friday. Early morning appointments with a GP, a practice and a health care assistant are available from 7.00am on Wednesday and Thursday mornings. Patients are also offered pre-bookable appointments on Saturdays and Sundays with Mastercall, the Out of Hours provider for the locality.

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 and cancel appointments and order prescriptions. 

Updated 15 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Adshall Road Medical Practice on 12 October 2016. Overall the practice is rated as good.

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

• The GP partnership had experienced changes, both expected and unexpected in the last 12 months and this had caused some challenges for the practice.
• 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 usually found it easy to get through to the practice on the telephone and could get an appointment with a named GP if they were willing to wait a couple of days. The GPs provided a telephone appointment service which patients said they liked.
• The GPs provided a telephone triage service for urgent appointments. These were available each 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.

The areas where the provider should make improvement are:

• Establish a programme of regular clinical audit and re-audit.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 15 November 2016

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

• Nursing staff supported by the GP partners had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• The practice’s performance was below the average of the Clinical Commissioning Group (CCG) and the England average in some of the diabetes indicators outlined in the Quality and Outcomes Framework (QOF) for 2014/15. Unverified data supplied by the practice showed there had been some improvement in performance in 2015/16. The practice nurse we spoke with confirmed a small group of patients with diabetes were resistant to participating in reviews of their condition.
• The practice encouraged patients to self refer to education programmes such as Expert for the management of diabetes and other long-term conditions.
• Longer appointments and home visits were available when needed 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 15 November 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 Clinical Commissioning Group (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.
• Quality and Outcome Framework (QOF) data for the public health indicators for 2014/15 showed that the practice’s performance for the percentage of women aged 25-64 who had received a cervical screening test in the preceding five years was 77%. This was slightly below the CCG average of 82% and the England average of 82%. Data, (not yet verified) supplied by the practice for 2015/16 showed the practice had improved its performance.
• QOF data for 2014/15 showed that 70% of patients with asthma, on the register, had received an asthma review in the preceding 12 months compared to the CCG average of 76% and England average of 75%. Data supplied by the practice (unverified) for 2015/16 showed that 100% of patients benefited from a review.
• We heard about positive examples of joint working with midwives, health visitors and school nurses.

Updated 15 November 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.
• A minimum of weekly telephone contact with a local care home was undertaken and patients received GP visits as required.
• Monthly multi-disciplinary team meetings were held in the local neighbourhood to review specific patients considered at high risk.
• The practice was proactive in supporting patients on the palliative care register and used the electronic communication tool -Electronic Palliative Care Coordination Systems (EPaCCS) to record information that was accessible to the Out of Hours provider and the local hospital.
• A member of staff had recently been designated as a cancer champion.

Updated 15 November 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 flexible surgery times including early morning appointments from 7.00 am on Wednesday and Thursdays. Appointments were available with GPs, practice nurses and health care assistants on these early mornings. Pre-bookable telephone consultations were also available.
• The practice was proactive in offering online services such as booking and cancelling appointments and ordering prescriptions.
• The practice website also offered information on health promotion and screening.

Updated 15 November 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 78% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was below the Clinical Commissioning Group (CCG) average of 87% and the England average of 84%. Data supplied by the practice for 2015-16 showed that the practice had improved their performance with 95% of patients benefiting from a face to face review.
• 87% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan recorded in the preceding 12 months, which was lower than the CCG average of 91% and the England average of 88%. However, the practice’s clinical exception reporting rate was also lower at 5% compared to the CCG average of 9% and the England average of 13%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients 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.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 15 November 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 and those 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.