Lockside Medical Centre

Updated 26 September 2016

Lockside Medical Centre provides primary medical services in Stalybridge, Tameside from Monday to Friday. The surgery is open:

Monday 9:00am to 12:30pm and 1:30pm to 6:00pm

Tuesday 8:00am to 12:30pm and 1:30pm - 8:30pm

Wednesday 9:00am to 12:30pm and 1:30pm to 6:00pm

Thursday 9:00am to 12:30pm and 1:30pm to 6:00pm

Friday 9:00am to 12:30pm and 1:30pm to 6:00pm

Appointments are from 9:00am to 11:30am and 3:00pm to 5:30pm Monday to Friday. Extended appointments are available Tuesdays from 8:00am and evenings until 8:00pm. The practice also participates in a local extended hours scheme in which patients are able to access GP appointments at a local hub evenings and weekends.

Stalybridge is situated within the geographical area of Tameside and Glossop Clinical Commissioning Group (CCG).

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

Lockside Medical Centre is responsible for providing care to 7464 patients.

The practice consists of five GP partners and one salaried GP, three of whom are female. The practice employ a pharmacist, practice nurses, one of whom is a nurse prescriber, health care assistant, patient advisors and phlebotomists. The practice is supported by a practice manager, assistant practice manager, patient advisor manager, information systems manager, receptionists, administrators and cleaners.

The practice was a training practice and had two GP trainees at the time of our inspection.

When the practice is closed patients are directed to the out of hours service Go-To-Doc via 111.

Updated 26 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Lockside Medical Centre on 27 July 2016. Overall the practice is rated as outstanding.

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

• Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed, including those relating to recruitment checks.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example a team lead by a GP working with patients over 75 years and the introduction of an holistic annual review programme for patients with long term health conditions.

• Data showed patient outcomes were above those locally and nationally, including unplanned hospital admissions.
• Feedback from patients about their care was consistently and strongly positive.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. The practice valued continuity of care for patients and working as a team had improved continuity of care. Data from the GP national survey published in July 2016 showed that 83% of patients stated they were able to see their usual GP compared to the CCG average (60%) and national average (59%).
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a result of feedback from patients.

• Information about services and how to complain was available and easy to understand.

• Patients said they found it easy to make an appointment and that there was continuity of care, with urgent appointments available the same day. The practice embraced new ways of working including online access and email consultations.

• 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 practice embedded quality improvement into all areas of work. The strategy and supporting objectives were clear, owned by all the staff, monitored regularly, challenged, while remaining achievable.

We saw areas of outstanding practice, including:

• There was a holistic approach to assessing, planning and delivering care and treatment to people who use services. For over three years the practice have adopted a process of continuous quality improvement and small cycles of change, a process which exceeds a clinical audit system by embedding and sustaining outcomes. We saw the detail and wide range of interventions being monitored clearly displayed on a performance board for all staff. We were provided with a wide range of quality improvement work and key performance indicators set by the practice team, for example: the length of stay project, continuity of care, telephone access and safe prescribing of medicines such as antibiotics.
• The practice employed a team including a GP for 3.5 sessions a week to provide care for those patients over 75 years. The GP was supported by a HCA and patient support worker. The care included a weekly review of patients within residential/nursing homes, a hospital in reach service, visiting patients on discharge from hospital and carrying out regular reviews of housebound patients. Additionally the patient support worker also provided holistic care and support to those patients over 75 who were not in residential/nursing homes but who had one or more chronic disease. Data showed that following the introduction of the scheme the practice had a lower than the local average rate of unplanned hospital admissions and shorter length of stay in hospital.
• The practice had established a programme of work to reduce the length of stay patients experienced following an unplanned hospital admission. The practice was looking to see if GP intervention could improve discharge rates. This was achieved by monitoring a daily list of patients in hospital, a GP contacted clinicians on the ward to share patient history and knowledge of those patients. GPs would then offer to support continued assessment and re-enablement in the community. As a result the practice liaised with the hospital discharge lead and had direct contact with ward discharge facilitators to aid communication and enabled, where possible, early discharge. The practice identified a number of barriers to the work in the initial phase but had established successful lines of communication and had several examples of successful early discharges. Early indicators showed as a result of the work, on average the number of bed days used by Lockside patients had reduced and was lower in comparison with neighbourhood practices.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 26 September 2016

The practice is rated as outstanding 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.
• Longer appointments and home visits were available when needed.
• The practice introduced a holistic annual review programme following a successful pilot in April 2016 for patients with long term health conditions. These reviews were scheduled annually around a patient’s birthday where patients were invited for a 40 minute appointment. A long term conditions clinical template had been devised to ensure a holistic review. The patients were provided with a detailed follow up letter which incorporated results and action plans discussed during the consultation, with the aim of empowering patients to take a lead on their own care.
• Patients with COPD and asthma had self-management plans and access to medication at home for acute exacerbations and were directed to a structured education programme. The practice offered referral to Self-Management UK who provide 6 week support courses for patients with long term conditions.

Updated 26 September 2016

The practice is rated as outstanding 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 good examples of joint working with midwives and health visitors. A midwife held antenatal clinics weekly.
• A contraceptive service including the fitting of contraceptive coils and implants was available for patients.

Updated 26 September 2016

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

• The practice offered proactive, personalised care to meet the needs of the older people in its population. Patients wherever possible were booked appointments with their usual GP to ensure continuity of care. Evidence from the practice showed continuity of care had improved as a result.
• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. Nursing and residential homes had an allocated GP and nurse, whenever possible these staff responded to patients’ needs within the home to ensure continuity of care.
• The practice employed a team including a GP for 3.5 sessions a week to provide care for those patients over 75 years. The GP was supported by a HCA and patient support worker. The care included a weekly review of patients within residential/nursing homes, a hospital in reach service, visiting patients on discharge from hospital and carrying out regular reviews of housebound patients. Additionally the patient support worker also provided holistic care and support to those patients over 75 who were not in residential/nursing homes but who had one or more chronic disease. Evidence from the work the over 75s team showed positive feedback from patients and their families, improved outcomes for patients and better use of community services. Data showed that following the introduction of the scheme the practice had a lower than the local average rate of unplanned hospital admissions and shorter length of stay in hospital. Evidence also showed for those patients at the end of life the care the scheme enabled more patients to have care in their place of choosing, for example, at home or in a hospice.
• The practice embraced the Gold Standards framework for end of life care. This included supporting patients’ choice to receive end of life care at home.

Updated 26 September 2016

The practice is rated as outstanding 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.
• Appointments were available outside of normal working hours, with one evening surgery and three early morning GP surgeries. There are also two early morning blood clinics.
• Telephone and email consultations were available for patients who were unable to attend the practice.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs of this age group.

Updated 26 September 2016

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

• 85% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months.
• 100% of patients with poor mental health had a comprehensive care plan documented in the record agreed between individuals, their family and/or carers as appropriate. Exception reporting was comparable to the CCG average.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• It carried out advance care planning for patients with dementia.
• The practice had told patients experiencing poor mental health how to access various support groups and voluntary organisations. The practice promoted self-referral to the local “Healthy Minds” service.
• It had a system in place to follow up patients who may have been experiencing poor mental health and had attended accident and emergency.
• Staff had a good understanding of how to support people with mental health needs and dementia.

Updated 26 September 2016

The practice is rated as outstanding 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.
• The practice Learning Disability Lead liaised with the local Specialist Needs Nurse to ensure the register of patients with learning disabilities was accurate and helped to signpost patients and their carers should they require additional support.
• Vulnerable patients were identifiable with alerts noted on the secure computer system to ensure staff were alerted to needs.
• Annual reviews were provided for patients with learning disabilities, using a nationally recognised tool.
• The practice was proactive in monitoring those patients identified as vulnerable or at risk. This included, monitoring A&E attendances, monitoring missed appointments from those known to be vulnerable and working with other services to ensure, where appropriate, information was shared to keep patients safe.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• It had told vulnerable patients about how to access various support groups and voluntary organisations.
• The practice provided primary care to residents of a local supported home which helped residents to tackle the issues that may prevent someone from sustaining independent living. The practice worked with support staff at the home to ensure that residents, registered with the practice, needs were met.
• 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.