Huntley Mount Medical Centre

Updated 24 March 2017

Huntley Mount Medical Centre is located in Huntley Mount Road, Bury Manchester BL9 6JA. There is local parking and free on site parking and disabled parking.  There are also public transport links close to the practice. Huntley Mount Medical Centre is situated within the geographical area of Bury Clinical Commissioning Group (CCG).

There is one male GP and two long term locum GPs, one male and one female. There are two practice nurses (both long term locums), a part time health care assistant and a part time locum pharmacist. All of these staff are female. The practice is supported by a practice manager and a team of reception and administration staff.

The practice is not a teaching practice but does take medical students.

The practice is open from 8 am to 6.30 pm Monday to Friday (except bank holidays). Appointments are between 8.30 am and 12.30 pm and 3 pm and 5.30 pm. Telephone appointments are available daily from 8 am to 6.30 pm.

Patients requiring a GP outside of normal working hours are directed to use the Bury and Rochdale Doctors On Call (BARDOC) using the surgery number.

The practice has a General Medical Services (GMS) contract with Bury CCG. The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.

Huntley Mount Medical Centre is responsible for providing care to 2931 patients.

Updated 24 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Huntley Mount Medical Practice on 19 May 2016. The overall rating for the practice was requires improvement. The practice did not have effective systems in place to assess the risk of and to prevent, detect and control the spread of health care associated infection. Thorough recruitment and selection procedures were not in place and there was no clear system for the recall of patients with long term conditions and those who did not attend their follow-up appointments. Within an agreed timescale the practice submitted an action plan which demonstrated they are now meeting the requirement notices from this inspection. The full comprehensive report on 19 May 2016 inspection can be found by selecting the ‘all reports’ link for Huntley Mount Medical Practice on our website at www.cqc.org.uk.

We carried out this announced comprehensive inspection at Huntley Mount Medical Practice on 24 January 2017. Overall the practice is now 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.

• Thorough recruitment and selection procedures were in place.

• There was a clear system for the recall of patients with long term conditions and those who did not attend their follow-up appointments.

• There was an infection control protocol in place and staff had received up to date training. Annual infection control audits were undertaken.

• 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 found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments 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 was an innovative approach to the practice child nasal flu campaign.Flyers sent to all local schools and nurseries with relevant aged children in September 2016. Letters were also sent to all parents promoting nasal flu vaccination. Discussions were held with the head teacher of one school and letters were sent out to all head teachers promoting the benefit of nasal flu vaccination.

Area of outstanding practice:

• The practice staff organised a dementia awareness day  working in consultation with national charities and local hospital consultants. This day was  open to all Bury patients.Staff were also arranging a crown green bowling event in the park opposite surgery with Bury Council funding; this was planned for Summer 2017.

The areas where the provider should make improvement are:

• A detailed analysis of significant events should take place with detailed records kept of the findings and actions taken to address any changes to practice.

• A record should be kept of meetings held for the purpose of monitoring issues discussed.

• More detailed information needs to be recorded in clinical audits and a plan should be drawn up for the completion of future audits.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 March 2017

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

• GPs, nursing staff and the pharmacists had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Performance for diabetes related indicators was below the CCG and the national average, for example, the percentage of patients with diabetes, on the register, in whom the last HbA1c was 64mmol/mol or less in the preceding 12 months was 51% compared to the CCG and national average of 78%.  On the day of the inspection the GP provided us with evidence to demonstrate improvements in this area. This evidence demonstrated that the percentage of patients with diabetes, on the register, in whom the last HbA1c was 64mmol/mol or less in the preceding 12 months was 72% compared to the CCG and national average of 78%. 

• 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 care professionals to deliver a multidisciplinary package of care.
• Educational videos were played in the patient waiting area.
• Combined flu and pneumonia campaigns were carried out.
• GPs and nursing staff worked with local drug and alcohol support services.
• Patients were referred to Bury Exercise and Therapy Scheme for lifestyle improvement advice and information.
• The practice had completed the Gold Standard Framework Silver Programme for providing end of life care and regular palliative care meetings took place with relevant health care professionals.
• Clinical staff held regular cancer care reviews and arranged support as needed.

Updated 24 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 patients who had a high number of accident and emergency attendances. Immunisation rates were relatively high for all standard childhood immunisations.
• There was an innovative approach to the practice child nasal flu campaign. Flyers were sent to all local schools and nurseries with relevant aged children in September 2016.Letters were also sent to all parents promoting nasal flu vaccination. Discussions were held with the head teacher of one school and letters were sent out to all head teachers promoting the benefit of nasal flu vaccination.  Training on this strategy was given at a nurse immunisation training course.  the practice provided data to indicate they had achieved 67% of patients receiving a nasal flu vaccination in 2015 /2016. 
• 68% of women aged 25-64 had a cervical screening test performed in the preceding 5 years compared to the CCG average of 82% and the national average of 81%. On the day of the inspection the GP provided us with evidence to demonstrate improvements in this area. This evidence demonstrated that  the practice uptake for the cervical screening was 81%. 
• 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.
• Advice was available on contraception, cervical screening and breast assessment as well as well woman checks and NHS Health Checks.

• Midwives provided pre pregnancy counselling and antenatal care.
• Sexual health advice and checks were given along with chlamydia screening.
• Childhood vaccinations, flu and pneumonia vaccinations were provided for at risk groups.
• Patients were referred to the Bury health trainers and Bury Exercise and Therapy Scheme for advice on maintaining a healthy lifestyle including advice on smoking cessation.
• A local drug and alcohol team held regular clinics at the surgery.
• Telephone appointments were available.
• Clinicians were trained in child health surveillance.
• Staff promoted the Big White Wall, a local on-line pilot scheme to support 16-25 year olds with mental health problems.

Updated 24 March 2017

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

• The practice offered proactive, personalised care plans and assessments to meet the needs of the older patients in its population.
• Patients aged over 75 years had a named GP.
• The practice was responsive to the needs of older patients, and offered home visits, medication reviews and urgent appointments for those with enhanced needs.
• The practice monitored patients over the age of 65 years and supported the national screening programmes with regard to providing health checks for breast and bowel screening and abdominal aortic aneurysm screening.
• General health checks were provided along with well man and woman checks.
• NHS Health Checks were provided for 40-74 year old patients.
• Flu, pneumonia and shingles vaccination clinics were held.
• Memory screening and dementia assessment/follow-up appointments were provided.
• Palliative care meetings took place to discuss patients who needed end of life care.
• Regular cancer care reviews took placed with the necessary support arranged as needed.
• A health trainer ran a weekly clinic from the practice offering patients advice on smoking and alcohol cessation and maintaining a healthy lifestyle.
• Staff encouraged carers to register with the practice. They were offered flu vaccinations health checks as needed.
• A hearing loop was offered for patients with hearing difficulties.

Updated 24 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.

• Pre- bookable appointments and late evening appointments were available. Weekend appointments were available at the practice via the out of hour’s service.
• On-line prescription requests were available.
• Telephone consultations were available with the GPs and practice nurses.
• A local drug and alcohol team held regular clinics at the practice.
• A health trainer ran a weekly clinic from the practice offering patients advice on smoking and alcohol cessation and maintaining a healthy lifestyle.
• Patients were provided with information about how to refer themselves to the Healthy Minds counselling service.
• GPs provided the meningitis vaccination for university students.
• The surgery promoted a local scheme called Helping Yourself to Wellbeing. This local scheme was designed to provide patients with the knowledge, skills and tools to improve their health and wellbeing.

Updated 24 March 2017

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

• 89% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, compared to the CCG average of 88.73% and the national average of 84.01%.
• 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. Memory screening and dementia assessments with follow-up appointments were available with the same GP to ensure continuity of care.
• The staff had organised a dementia awareness day in the local community centre. Staff were also arranging a crown green bowling event in the local with Bury Council funding; this was planned for Summer 2017.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• The practice had a system 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. Staff worked closely with the Alzheimer’s Society and GPs were trained in dementia care.

• Same day or next day appointments with a GP and longer appointments were available.
• GPs had regular contact with a local consultant psychiatrist for daily advice and support. GPs worked with Making Space, a local voluntary organisation for patients with dementia.
• Military Veteran services available were on site for all Bury CCG patients.

Updated 24 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, travellers 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.

• There was a list of patients who may be at risk of abuse and harm and these patients were discussed regularly with relevant health care professionals.

• Annual health checks were available to patients with a learning disability.