Archived: Manningham Medical Practice

Updated 25 November 2016

Manningham Medical Practice provides services for 3,661 patients and is situated at Lumb Lane, Bradford, BD8 7SY.

Manningham Medical Practice is situated within the Bradford City Clinical Commissioning group (CCG) and provides primary medical services under the terms of an alternative provider medical services (APMS) contract. This is a contract between general practices and NHS England for delivering services to the local community.

They offer a range of enhanced services such as childhood immunisations, extended hours, and facilitating timely diagnosis and support for people with dementia.

The National General Practice Profile shows that the age of the practice population is slightly different to the national average with lower numbers of patients aged over 45 and higher numbers of patients aged below 44. This is in common with the characteristics of the Bradford City area. The profile shows that 69% of the practice population is from a south Asian background with a further 9% of the population originating from black, mixed or non-white ethnic groups.

There is one salaried female GP at the practice and male and female locum GPs are used for additional cover. The practice is staffed by two practice nurses and one advanced nurse practitioner and has two health care assistants (HCA’s) all of whom are female. The staff team is reflective of the population it serves and are able to converse in several languages including those widely used by the patients, Urdu, Punjabi, Bengali and English.

The clinical team is supported by a practice manager and a team of administrative staff.

The practice is operated by Local Care Direct who are a social enterprise company. The corporate team includes management staff including a nurse manager, a clinical governance lead and an infection prevention and control lead who support the day to day management of the practice.

The practice catchment area is classed as being within one of the most deprived areas in England. People living in more deprived areas tend to have a greater need for health services. Male life expectancy is 72 years compared with a CCG average of 73 and a national average of 79. Female life expectancy is 78 years, CCG average 79, national average 83.

Manningham Medical Practice is situated in a purpose built building with good access for less mobile patients, with all clinics being held on the ground floor. It has disabled facilities.

The practice reception is open between 8am and 8pm Monday and Tuesday and between 8am and 6pm Wednesday, Thursday and Friday.

Surgery hours are from 8.10am until 7.30pm on a Monday and between 8.10am and 6pm Tuesday to Friday.

The surgery is closed on a Saturday and Sunday.

The Out of Hours walk-in service is provided by Local Care Direct at Hillside Bridge Health Centre. Patients are also advised of the NHS 111 service.

Updated 25 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Manningham Medical Practice on 25 October 2016. Overall the practice is rated as good.

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

• The safety of staff and patients was a priority of the practice and there was an effective system in place for reporting and recording significant events. These were reviewed within the practice and by the provider.
• Risks to patients were assessed and well managed.

• 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. Staff were encouraged to attend additional training and the practice supported the learning and development of all staff.
• Patients said they were treated with compassion, dignity and respect.
• 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 did not find it easy to make an appointment with a named GP and there was not always continuity of care. Urgent appointments were available with both GPs and nursing staff the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• A health advisor was available for one afternoon per week. The practice also offered access to an in-house benefits advisory service every Monday, where patients could get help with benefits, claims, forms, immigration and debt issues.
• We saw that the practice carried out comprehensive checks for locum GPs and had recently implemented “end of shift” forms. These tick lists encouraged locum GPs to review their responsibilities and work load and were handed to the practice manager prior to leaving the practice. The practice also provided a one page quick reference guide for locums and a more detailed file was kept in each clinic room which would assist with referrals, protocols and contacts for example.
• There was a clear and effective leadership structure. Staff felt very supported by the management in the practice and also by the wider management team. 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 practice had a patient engagement lead and an active Patient Participation Group (PPG).

The areas where the provider should make improvement are:

The practice should review the results of patient satisfaction surveys, including the GP patient survey and ensure that it can meet the needs of their patient population in the future and improve access.

Review their arrangements for clinical audit at the practice. Clinical audits should be clearly linked to patient outcomes, monitored for effectiveness and be comprised of two or more cycles to monitor any improvements made to patient outcomes.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 November 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 held a diabetes clinic weekly where the practice nurse was supported by a health advisor who was fluent in three languages relevant to the patient population. On alternate weeks this clinic would also include a dietician and blood glucose levels could also be assessed and reviewed.
• Longer appointments and home visits were available when needed. For example, reviews for diabetic patients were 30 minutes long and would include demonstrations of how to carry out chair exercises for the less mobile.
• The practice population was identified as being at risk of developing diabetes. The practice participated in CCG led initiatives and the HCA had developed a basic “Are you at Risk?” pack which was available in reception and gave patients some basic information regarding diabetes.
• 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.
• The practice offered ECG’s, 24 hour blood pressure monitoring, Doppler tests (an ultrasound test that uses high frequency sound waves to measure the amount of blood flow through your arteries and veins), and spirometry testing. (Spirometry is a test that can help diagnose various lung conditions, most commonly chronic obstructive pulmonary disease (COPD). Spirometry is also used to monitor the severity of some other lung conditions).

Updated 25 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 accident and emergency (A&E) attendances. Immunisation rates were comparable to CCG and national averages 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. Urgent appointments were available the same day.
• The percentage of women aged between 25 to 64 whose notes recorded that a cervical screening test had been performed in the preceding five years was 79% which was in line with the CCG average of 76% and national average of 81%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw the practice offered access to midwives, health visitors and school nurses. A joint clinic conducted by the practice nurse, health visitor and a GP was held every week.
• The practice maintained close links with the district nursing and health visiting teams. The midwifery team were situated in the same building.

Updated 25 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 and liaised with the community matron to manage their needs.
• The practice was responsive to the needs of older people, and offered home visits for urgent needs, health monitoring and flu vaccinations. An interpreter would be taken on a home visit if required.
• There were urgent appointments for those with enhanced needs.
• All the patients in this age group had a named GP.

Updated 25 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 held an extended hours clinic on a Monday until 7.30pm and patients could access GP and nursing appointments from 8.10am.
• Patients could book appointments up to two weeks in advance and on line services were available.
• Text message reminders were sent to patients to remind them to attend their booked appointments.
• The practice was proactive in offering a full range of health promotion and screening that reflects the needs for this age group.

Updated 25 November 2016

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

• 88% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which was higher than the CCG average of 86% and national average of 84%.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a record of blood pressure in the preceding 12 months was 97% compared to the CCG and national average of 89%.
• 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 and were offering physical health checks for patients with severe mental illness.
• 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. Opportunistic dementia screening was carried out as appropriate and any concerns were referred to the GP.
• The practice had identified a low prevalence of dementia within their population and were being more proactive to identify those at risk.

Updated 25 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 at risk of unplanned hospital admissions, travellers and those with a learning disability.
• The practice had identified 18 patients with a learning disability and offered longer appointments, care plans and annual health checks for these patients. The team had recently met with the local learning disability community team to update their knowledge
• 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 for example, carers’ support.
• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were clear with regards to their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.
• A health advisor was available for one afternoon per week and the practice offered access to an in house benefits advisory service every Monday where patients could get help with benefits, claims, forms, immigration and debt issues.