Dr Laurence Howard Sherman Also known as Greyland Medical Centre

Updated 11 January 2017

The practice had been previously inspected on 19 May 2015. Following that inspection the practice was rated requires improvement.

This practice is located in Manchester and provides services from a two storey building, however all clinical appointments take place on the ground floor. At the time of our inspection there were 2118 patients registered with the practice. It is a member of NHS Bury Clinical Commissioning Group (CCG).

The age profile of the practice is very similar to the CCG and national averages. The male life expectancy for the area is 78 years compared with the CCG averages of 78 years and the national average of 79 years. The female life expectancy for the area is 83 years compared with the CCG averages of 81 years and the national average of 83 years.

There is one GP supported by a practice nurse. There is also a practice manager with a supporting reception and administration team.

The practice delivers commissioned services under the General Medical Services (GMS) contract. It offers direct enhanced services for the childhood vaccination and immunisation scheme, extended hours access, facilitating timely diagnosis and support for people with dementia, influenza and pneumococcal immunisations, minor surgery, rotavirus and shingles immunisation and unplanned admissions.

The practice is open between 8am and 6.30pm Monday to Friday. Extended hours surgeries are offered one night per week, usually a Wednesday, from 6.30pm to 7.45pm. Patients can book appointments in person or via the phone. Emergency appointments are available each day. There is an out of hours service available provided by Bury and Rochdale Doctors (BARDOC).

Updated 11 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Laurence Howard Sherman on 6 December 2016. Overall the practice is now rated as good.

The practice had been previously inspected on 19 May 2015. Following that inspection the practice was rated overall requires improvement with the following domain ratings:

Safe – Requires improvement

Effective – Good

Caring – Good

Responsive – Good

Well-led – Requires improvement

Two requirement notices were issued as the practice was not meeting the legislation in place at that time for the following:

• Regulation 12 Health & Social Care Act 2008 (Regulated Activities) Regulations 2014: Safe care and treatment
• Regulation 13 Health & Social Care Act 2008 (Regulated Activities) Regulations 2014: Safeguarding service users from abuse and improper treatment.

Following this re-inspection on 6 December 2016, our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and a 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 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.

The areas where the provider should make improvements are:

• The practice should ensure they have access to a defibrillator on the premises and oxygen with adult and children’s masks. However at this inspection we saw evidence that the practice already had submitted plans to procure these items as a matter of urgency.

We saw one area of outstanding practice:

• The practice had achieved the best results for the uptake of seasonal influenza vaccine in the local Clinical Commissioning Group area for 2015/16. The GP not only delivered the programme in the surgery but also made numerous home visits to ensure that their eligible patient population had the opportunity to receive the vaccine in a timely manner.  As a result of this the GP was invited by Public Health Bury to attend the Seasonal Flu Group to share good practice with other colleagues. 

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 11 January 2017

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

• The practice nurse had a lead role in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Longer appointments and home visits were available when needed.
• All these patients had a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 11 January 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 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 examples of joint working with midwives and health visitors.

Updated 11 January 2017

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.

Updated 11 January 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 a full range of health promotion and screening that reflects the needs for this age group.

Updated 11 January 2017

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

• 96% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is better than the Clinical Commissioning Group (CCG) and national averages.
• 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.
• 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 11 January 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 those with a learning disability and asylum seekers.
• 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.