Dr Robert Mathewson

Updated 21 December 2016

Dr Robert Mathewson, also known as ‘High Lane Medical centre’ is located in Stockport, Greater Manchester. The practice was providing a service to approximately 5,400 patients at the time of our inspection.

The practice is part of Stockport Clinical Commissioning Group (CCG). The practice is situated in an area with low levels of deprivation when compared to other practices nationally. The practice population is made up of a higher than average elderly population with 41% of the population aged over 65 years old. The percent of the patient population with a long standing health condition is 57% which is slightly higher than the nation average of 54%.

The practice is run by one GP and there are four salaried GPs (three male and two female). There are two practice nurses, one health care assistant, a practice manager and a team of reception/administration staff.

The practice is open from 8am to 6.30pm Mondays, Thursdays and Fridays and 8am to 8pm on Tuesdays and Wednesdays. When the practice is closed patients can access the out of hours service provided by ‘Mastercall’ by calling 111.

Patients can book appointments in person, via the telephone or online. The practice provides telephone consultations, pre-bookable consultations, urgent consultations and home visits. The practice treats patients of all ages and provides a range of primary medical services.

The practice has a Personal Medical Services (PMS) contract. The practice provides a range of enhanced services, for example: extended hours, childhood vaccination and immunisation schemes, checks for patients who have a learning disability and avoiding unplanned hospital admissions.

Updated 21 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Robert Mathewson, also known as ‘High Lane Medical Centre’ on 12 October 2016. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.
• Significant events had been investigated and action had been taken as a result of the learning from events.
• Systems were in place to deal with medical emergencies and staff were trained in basic life support.
• There were systems in place to reduce risks to patient safety. For example, infection control practices were good and there were regular checks on the environment and on equipment used.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Data showed that outcomes for patients at this practice were similar to outcomes for patients locally and nationally.

• Feedback from patients about the care and treatment they received was very positive. Patients said they were treated with dignity and respect and they were involved in decisions about their care and treatment.

• Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Staff felt well supported in their roles and had undergone a regular appraisal of the work.
• The practice had good facilities, including disabled access. It was well equipped to treat patients and meet their needs.
• Information about services and how to complain was available. Complaints had been investigated and responded to in a timely manner.
• The practice had a clear vision to provide a safe and high quality service.
• There was a clear leadership and staff structure and staff understood their roles and responsibilities.
• The practice provided a range of enhanced services to meet the needs of the local population.

Area of outstanding practice:

• The practice provided a well managed and responsive appointments system which resulted in very high levels of patient satisfaction.

Areas where the provider should make improvement are:

• Introduce a record to demonstrate the actions taken for all safety alerts.

• Ensure all staff are provided with the appropriate level of safeguarding training.

• Carry out a risk assessment with regards to the practice not having a defibrillator available on site.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 December 2016

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

• The practice held information about the prevalence of specific long term conditions within its patient population. This included conditions such as diabetes, chronic obstructive pulmonary disease (COPD), cardio vascular disease and hypertension. The information was used to target service provision, for example to ensure patients who required immunisations received these.

• Regular, structured health reviews were carried out for patients with long term conditions.

• GPs had lead roles in some chronic diseases such as hypertension and diabetes

• Patients with several long term conditions were offered a single, longer appointment to avoid multiple visits to the surgery.

• Data from 2015 to 2016 showed that the practice was performing in comparison with other practices nationally for the care and treatment of people with chronic health conditions such as diabetes.

• The practice provided an enhanced service to prevent high risk patients from unplanned hospital admissions. This included these patients having a care plan and a regular review of their medicines.

• A member of staff had a designated care co-ordinator role to contact patients following an emergency admission to hospital.

• The practice held regular clinical and multi-professional meetings to discuss patients with complex needs and patients receiving end of life care.

• The practice provided an in house phlebotomy service five days per week and patients were accommodated to have a blood test directly following their appointment when this was possible.

Updated 21 December 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 those who were at risk, for example, children and young people who had a high number of A&E attendances. A GP was the designated lead for child protection.

• Staff we spoke with had appropriate knowledge about child protection and they had ready access to safeguarding policies and procedures.

• Child surveillance clinics were provided for 6-8 week olds.

• Immunisation rates were generally comparable to the national average for standard childhood immunisations. Opportunistic immunisations were given to encourage uptake

• The practice monitored non-attendance of babies and children at vaccination clinics and staff told us they would report any concerns they had identified to relevant professionals.

• Family planning services were provided and the practice had a lead for women’s health. The percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed within the target period of 5 years was 83% which was comparable to the national average of 81%.

• Babies and young children were offered an appointment as priority and appointments were available outside of school hours.

• The premises were suitable for children and babies and baby changing facilities were available.

Updated 21 December 2016

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

• The practice offered proactive, personalised care and treatment to meet the needs of the older people in its population. The practice kept up to date registers of patients with a range of health conditions (including conditions common in older people) and used this information to plan reviews of health care and to offer services such as vaccinations for flu.

• Patients over the age of 75 had a named GP and a structured annual review to check that their health needs were being met.

• Care planning was carried out for patients with dementia care needs.

• One of the GPs held a lead role in elderly care and other GPs held lead roles in some conditions more commonly found in older people.

• Nationally reported data showed that outcomes for patients for conditions commonly found in older people were similar to local and national averages.

• GPs carried out regular visits to local care homes to assess and review patients’ needs and to prevent unplanned hospital admissions.

• Home visits and urgent appointments were provided for patients with enhanced needs.

• The practice used the ‘Gold Standard Framework’ (this is a systematic evidence based approach to improving the support and palliative care of patients nearing the end of their life) to ensure patients received appropriate care.

Updated 21 December 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.

• Extended hours appointments were provided until 8pm two evenings per week.

• Telephone consultations were provided and this was advantageous for people in this group as it meant they did not always have to attend the practice in person.

• The practice provided a full range of health promotion and screening that reflected the needs of this age group. Screening uptake for people in this age range was comparable to national averages.

• The practice was proactive in offering online services including the booking of appointments and request for repeat prescriptions. Electronic prescribing was also provided. 

Updated 21 December 2016

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

• Data about how people with mental health needs were supported showed that outcomes for patients using this practice were comparable to local and national averages.

• The practice worked with other health and social care professionals in the case management of people experiencing poor mental health, including those with dementia.

• The practice referred patients to support services such as psychiatry and counselling services.

• Care planning was carried out for patients with dementia care needs.

• Some staff had been provided with training in dementia awareness to support them in supporting patients with dementia care needs.

• A system was in place to follow up patients who had attended accident and emergency and this included where people had been experiencing poor mental health.

• Processes were in place to prompt patients for medicines reviews at intervals suitable to the medication they took.

• Patients experiencing poor mental health were informed about how to access various support groups and voluntary organisations.

Updated 21 December 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 in order to provide the services patients required. For example, a register of people who had a learning disability was maintained to ensure patients were provided with an annual health check and to ensure longer appointments were provided for patients who required these.

• The practice worked with other health and social care professionals in the case management of vulnerable people.

• 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.

• Patients could access social work advice and support at regular drop in sessions. A counselling service was also hosted at the practice.

• The practice was accessible to people who required disabled access and facilities and services such as a hearing loop system (used to support patients who wear a hearing aid) and translation services were available.

• Information and advice was available about how patients could access a range of support groups and voluntary organisations.