Archived: Trafford Health Centre

Updated 24 May 2017

Trafford Out of Hours Service is part of Mastercall Healthcare Limited. International House is the governance and administrative centre for the organisation. Mastercall Healthcare is a social enterprise organisation established in 1996, formed from the Stockport Doctors’ Co-operative.

The organisation provides a range of services across the North West of England, covering a population of around three million. Mastercall provides urgent out of hours telephone advice, treatment at treatment centres via an appointment system, and home visits to patients when appropriate.

Following patient assessment by NHS 111, patients are contacted by clinicians at Mastercall International House, and appointments made to attend Stockport or Trafford treatment centres. Trafford Out of Hours Service from 6.30pm until 11pm Monday to Friday and from 6.30pm Friday to 8am Monday morning.

Mastercall also provides the following services:

• Walk in centre co-located within the Urgent Care Unit at Trafford General Hospital

• A GP practice at Trafford Health Centre with around 4,000 registered patients

• Dental helpline services

• Trafford care co-ordination service

• Community intravenous therapy service

• Alternative to transfer service

• GP/Advanced Nurse Practitioner service for the ‘Wellspring’ homeless hostel

• Patient transfer service.

Our inspection focused on the GP out of hours service only.

Mastercall had access to 85 GPs, 18 nursing staff, of whom seven are triage nurses; seven are minor injuries nurses and four advanced nurse practitioners. In addition there are16 administrative staff, including non clinical call handlers; and four drivers across the two out of hours sites.

In 2016 Mastercall out of hours service carried out around 70,000 patient contacts. Of these, approximately 50% were telephone advice; 39% attended treatment centres (of which around 2% were provided with patient transport), and 11% received home visits.

Mastercall out of hours service operates from the following locations:

• International House, Pepper Road, Hazel Grove, Stockport SK7 4BW

• Trafford Out of Hours Service, Trafford General Hospital, Moorside Road, Davyhulme, Manchester M41 5SL.

  At the time of our inspection the provider was in the process of transferring the Trafford Out of Hours service from Trafford Health Centre to Trafford General Hospital. The new premises were co-located with Trafford Urgent Care Centre. The service was being delivered from temporary accommodation at the time of our visit. We were told the move would be fully completed by the end of the week in which we visited.

  Mastercall provides the GP out of hours service for NHS Stockport CCG and NHS Trafford CCG.

Updated 24 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Trafford Out of Hours GP Service (Part of Mastercall Healthcare) on 6 March 2017. Overall the provider is rated as good.

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

• The provider demonstrated an open and transparent approach to safety; and a clear cohesive system was in place for reporting, recording and providing feedback on significant events, identified risks, near misses, patient complaints and safeguarding referrals.
• The Quality and Safety Team held profiles relating to identified risks, complaints, significant events and safeguarding referrals. Risk ‘champions’ had been identified amongst the workforce to encourage high levels of reporting amongst staff.
• The service was monitored against the National Quality Requirements (NQRs) and Key Performance Indicators (KPIs). The data provided information to the provider and commissioners in relation to the level and quality of service being delivered. Where variations in performance were identified, the reasons for these were reviewed and action plans implemented to improve the service.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff received appropriate training and updating which provided them with the skills, knowledge and experience to deliver effective care and treatment.
• Performance monitoring processes were in place. Clinicians received weekly audits of their clinical practice using the Royal College of GPs (RCGP) urgent care tool the ‘Clinical Guardian’ system.
• The provider had developed in-house software to support individual ‘My Performance’ reports which benchmarked individual clinicians against their peers in relation to assessment outcomes, for example in relation to percentage of patients who received telephone advice, or who attended treatment centres or hospital.

• Following initial assessment by NHS111 service, patients were triaged by clinicians at International House and offered telephone advice, a face to face appointment at Stockport or Trafford; or a home visit, in accordance with the disposition (outcome) of the assessment.

• Information about services and how to complain was available on the provider website and in house at treatment centres. Complaints were investigated and patients received an apology and explanation of actions taken as a result of their complaint.

• Staff had access to safeguarding policies and procedures and received training appropriate to their role. Staff demonstrated their awareness of their safeguarding responsibilities in relation to vulnerable children and adults; including frequent callers to the service.

• Vehicles used to transport GPs to home visits were clean, well maintained and appropriately equipped. Patient Transport Services were available for those patients without transport, who needed to access a treatment centre

• There was a clear leadership structure within the organisation. Staff we spoke with described feeling supported by immediate and senior managers.

• The provider proactively sought feedback from staff and patients, and acted on this feedback.

• There were systems in place to provide integrated person-centred care. Staff had access to information relating to end of life care through the use of Special Patient Notes, EMIS viewer and Electronic Palliative Care Co-ordination System (EPaCCS).

• The provider was aware of, and complied with the requirments of the duty of candour.

We saw areas of outstanding practice:

• The provider was the first out of hours service to be awarded ‘Daisy’ accreditation, which originated from the National Dignity Council, and had been adopted by Community Healthcare Trusts for Tameside, Glossop and Stockport; for dignity in care. Dignity champions had been identified throughout the service to reinforce this approach.

However the provider should:

• Improve uptake of annual appraisals, particularly in relation to nursing staff.

• Continuously monitor, review and develop action plans in relation to their performance against National Quality Requirements.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 4 January 2017

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

• The practice was open from 8am until 8pm seven days a week.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Indicators for diabetes and other long term conditions were in line with local and national averages.

• 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 and care professionals to deliver a multidisciplinary package of care.

Updated 4 January 2017

The practice is rated as good for the care of families, children and young people.

• The practice was open from 8am until 8pm seven days a week.

• 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 relatively high 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.

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

Updated 4 January 2017

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

• The practice was open from 8am until 8pm seven days a week.

• 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.

• They supported patients living in residential and care homes and undertook two visits each year for holistic review.These visits were carried out by GPs and practice nurses and each patient had a holistic and informative care plan.

Updated 4 January 2017

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The practice was open from 8am until 8pm seven days a week.

• 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.

Updated 4 January 2017

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

• Performance for mental health related indicators was worse than local and national averages. The practice attained 89% which was 5% below the CCG average and 4% below the national average.

• The practice carried out advance care planning for patients 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 4 January 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice was open from 8am until 8pm seven days a week.

• The practice held, what they referred to as, a VIP register which included patients with dementia, learning disabilities, mental health issues, complex needs and safeguarding concerns. These patients were regularly reviewed and discussed to ensure that their needs continued to be met.

• 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.