Background to this inspection
Updated
17 August 2016
This practice is located in Marsh Green. The practice provides services in purpose built single storey accommodation. There is suitable patient access to the premises. At the time of our inspection there were 2842 patients registered with the practice.
From data produced in 2015 the practice has a significantly high deprivation score (55.7) compared to the CCG (24.9) and national (21.8) scores. There is a lower proportion of patients aged over 65 years old (6%) compared to the CCG (18%) and National (17%) averages. There is a higher number of patients (32%) aged 18 or under compared to the CCG (20%) and national (20%) averages. The male life expectancy for the area is 73 years compared with the CCG averages of 77 years and the national average of 79 years. The female life expectancy for the area is 77 years compared with the CCG averages of 81 years and the national average of 83 years.
There are two GPs (one male and one female) supported by a practice nurse and a healthcare assistant. There is also a practice manager and supporting administration and reception staff. The practice is a training practice for trainee GPs.
The practice delivers commissioned services under the Alternative Provider Medical Services (APMS) contract with NHS England and is part of Wigan Clinical Commissioning Group. It offers direct enhanced services for the childhood vaccination and immunisation scheme, facilitating timely diagnosis and support for people with dementia, learning disabilities, patient participation, remote care monitoring, rotavirus and shingles immunisation and unplanned admissions.
The practice is open from 8am to 8pm from Monday to Friday and 8am to 12pm on a Saturday.
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 Bridgewater Community Health Care Trust and commissioned by Wigan Borough CCG.
Updated
17 August 2016
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Intrahealth Marsh Green on 21 July 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.
- 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. However some patients expressed concerns over the difficulty in getting through to reception by phone at peak times.
- 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.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
17 August 2016
The practice is rated as good for the care of people with long-term conditions.
- The practice nurse supported by the GPs 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 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
Families, children and young people
Updated
17 August 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 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, school nurses and health visitors.
Updated
17 August 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.
- All patients in this population group had a named accountable GP.
Working age people (including those recently retired and students)
Updated
17 August 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 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.
People experiencing poor mental health (including people with dementia)
Updated
17 August 2016
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).
- 70% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is below the CCG and the national average, both 84%.
- 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.
People whose circumstances may make them vulnerable
Updated
17 August 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 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.