Archived: City Health Centre

Updated 17 March 2016

City Health Centre is located in the heart of Manchester city centre. It is part of and managed by GTD healthcare, a not for profit social enterprise, and is overseen North Manchester Clinical Commissioning Group (CCG). At the time of our inspection 8,014 patients were registered and the practice is a training practice.

The practice has a varied population group, the main population group being aged between 15- 44 years which accounts for 91.6 % of the practice population, with small patient numbers in the areas of :

• Over the age of 65 years, which is only 0.42% of the population
• Long term conditions, which is only 9.5% of the population

The practice is located within Boots the Chemist, on the second floor. There is an access lift to the second (or keep 2nd but change the line above) floor which is suitable for disabled patients, with the nearest parking available within the Arndale Shopping Centre.

The practice has seven GPs (four male and three female). There are four advanced nurse practitioners (ANP) , one nurse practitioner (NP) and one healthcare assistant (HCA). Members of clinical staff are supported by one practice manager and 11 administrative staff.

The practice is open 8 am to 8pm, seven days a week and provides an unscheduled walk in centre at the same site. This means that patients can have access to the walk in centre in emergencies.

The practice has an Alternative Primary Medical Services (APMS) contract. The APMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.

Updated 17 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at City Health Centre on 16 February 2016. Overall the practice is 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, with a central reporting system to head office.
• The practice had a strong emphasis on safeguarding and protecting the most vulnerable patients.
• Risks to patients were assessed and well managed, with extra support to support the complex needs best suited to a city centre population.
• 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.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Patients said they found it very easy to make an appointment and that there was continuity of care, with urgent appointments available the same day. However patients found the telephone system poor.
• 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.

We saw several areas of outstanding practice:

• The practice was open 8am -8pm, seven days per week for patients, with the practice providing its emergency service for their patients.
• The practice supported the community and visited the Manchester homeless centre where free flu vaccinations and hygiene packs were provided to the homeless. They also provided a daily drop in appointment session to the homeless.
• The practice supported and visited the local LGBT (Lesbian, Gay, Bisexual, and Transgender) centre to offer health checks and other services. The practice supports a high number of LGBT patients and works at the local LGBT centre where they offer free advice and health checks.

The areas where the provider should make improvements by :

• Healthcare assistant should receive more formal training around infection control, to maintain the role effectively.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 March 2016

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

• 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 offers patients education and support, by providing information to manage their conditions more effectively. This included working with community health services, for example working with the respiratory team.
• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• The percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) was 140/80 mmHg or less 01/04/2014 to 31/03/2015) was 68.7% compared to the national average of 78%.
• Longer appointments and home visits were available when needed.

Updated 17 March 2016

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

• The practice offered a child surveillance programme, which involved clinics being run at weekends for parents.
• There were robust systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk. For example, the practice had a policy with a clear process, for children who did not attend for an appointment.
• The percentage of patients with asthma, on the register, who had had an asthma review in the preceding 12 months that included an assessment of asthma control using the 3 RCP questions. (01/04/2014 to 31/03/2015) was 84.3% compared to national average of 75.3%.
• 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 17 March 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.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice participated in meetings with other healthcare professionals and social services to discuss any concerns.
• There was a named GP for the over 75s with longer appointments when required.

Updated 17 March 2016

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

• The practice was open 8am -8pm, seven days per week for GP appointments.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that the needs for this age group. One example was patients were able to book an appointment online.
• The practice offered working parents clinics for child immunisation at weekends.
• 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.

Updated 17 March 2016

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

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those who are homeless.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• 90.9 % of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan recorded.
• 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.

Updated 17 March 2016

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

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their own responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.
• The practice were extremely proactive and offered the homeless in the city centre a daily drop in appointment.
• The practice held a register of patients living in vulnerable circumstances including homeless people.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.