Washway Road Medical Centre

Updated 19 April 2016

The practice is situated at 57 Washway Road on the main A56 and offers services to 15,000 patients within the surrounding catchment area of Sale. A smaller catchment area has been set up to accept new patients. There is ample car parking, disabled car parking and disability access, facilities for the hard of hearing, mother and baby facilities and an independent pharmacy on the site.

They provide a range of General Medical Services and offer additional services such as minor surgery, joint injections, coils and implants, phlebotomy, services into surrounding care homes and alcohol interventions. They also provide Directed Enhanced Services (DES) which are incentive based schemes linked to nationally agreed priorities for patients. Those included timely diagnosis of patients with dementia, minor surgery, immunisations and profiling and case management, which checks high risk patients on a quarterly basis and ensures they receive the most appropriate interventions.

The practice staff consist of a mixture of nine male and female GP partners, two non-clinical partners (practice managers), two nurse practitioners, two practice nurses, and a health care assistant. The clinical staff are supported by a number of administration and reception staff. They are a teaching and training practice of medical students and junior doctors and currently are training two GP registrars who see patients under supervision.

The practice doors open 8am until 6.30pm Monday, Tuesday, Thursday and Friday. General telephone lines are open 8.30am until 6.30pm Monday to Friday. On Wednesday the practice doors open at 7.15am until 6.30pm and is closed between 1pm and 2pm for training. Appointments are available at staggered times during those hours to make best use of car parking space and optimise appointment times to suit patient need and GP availability. Extended hours appointments are available until 7pm on two evenings each week and Saturday morning appointments are available at a local practice. Appointments can be made by telephone, attending at the practice, using the website or by text.

Updated 19 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Washway Road Medical Practice on 19 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.
• Risks to patients were assessed and well managed with exception of a risk associated with the duty doctor role.
• 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.
• The practice participated in the Trafford Care Co-ordination Service supporting patients admitted and discharged from hospital, sharing relevant information, and ensuring patients received appropriate follow up 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.
• Patients said they found it easy to make an appointment, but not with a named GP. Urgent appointments were 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 and the provider was aware of and complied with the requirements of the Duty of Candour.

• The practice regularly supported national campaigns. In January 2016 they promoted cervical cancer prevention, highlighting and encouraging females to attend screenings and in February they were supporting the British Heart Foundation’s Beat it campaign encouraging patients to give up smoking.

We saw several areas of outstanding practice:

• The partners at the practice were instrumental in education within the practice and throughout the Clinical Commissioning Group.For example, one of the partners had been the education lead for Trafford CCG since 2009 and had in that time implemented the quarterly Trafford-wide education event which offered an opportunity for clinicians and practice managers to stay informed and up to date with current practice and policy. They also hosted the GP forum which was a monthly clinical meeting with guest speakers and educational debates.

• The staff at the practice demonstrated evidence where they had gone over and above requirements on occasions and perceived these examples to be part of their everyday core services such as helping vulnerable patients and creating leaflets, booklets and information packs to improve patient knowledge/self-help and fundraising. They were the only people to attend the funeral of a patient who lived alone with no relatives.

We also saw areas where the practice should improve :

• Audits did not always demonstrate improvement. Performance for some of the QoF indicators remained lower than the national average despite identification and increased prevalence in these areas.In particular these related to diabetes, chronic obstructive pulmonary disorder (COPD) and asthma related indicators where there were large variations compared to the national averages.

• Nursing staff responsible for patients with long term conditions such as those mentioned above did not cross cover.

• Most risks to patients were assessed and well managed. However significant events had identified that the role of the duty doctor required further review to establish whether it was necessary to reduce workload and increase patient safety.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Updated 19 April 2016

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

• Nursing staff had lead roles in chronic disease management such as diabetes, COPD and asthma. However the nursing staff did not cross cover.

Three of the performance indicators for patients with long term conditions were significantly lower than the national average.

• The percentage of patients with asthma, on the register, who had an asthma review in the preceding 12 months that included an assessment of asthma control using the 3 RCP was 63% compared to the national average of 75%.

• The percentage of patients with COPD who had a review undertaken including an assessment of breathlessness using the Medical Research Council dyspnoea scale in the preceding 12 months was 77% compared to the national average of 89%.

• The percentage of patients on the diabetes register with a record of a foot examination and risk classification within the preceding 12 months was 73% compared to the national average of 88%.

Each clinical area had a GP lead with overall responsibility and longer appointments and home visits were available when needed.

Patients at risk of hospital admission were identified as a priority and given longer appointments when required.

Updated 19 April 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. This was achieved in part due to a selection of Saturday morning clinics held specifically for 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 and health visitors.

• The practice took a positive approach to identify and engage with patients and families with alcohol dependence.

Updated 19 April 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. They were was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• The practice provided on-site phlebotomy clinics. Patient feedback had evidenced a positive impact on older patients who could make appointments at the practice meaning they did not have to travel long distances and wait long times at drop in clinics.

• They took part in local enhanced services for the elderly, and had improved on the protocol by developing standardised templates for clinical assessment, medicine optimisation and advanced care planning. They had upgraded their clinical system to alert clinicians of those patients at risk of dementia.

• They had successfully bid to provide general medical services to a local intermediate care facility.

Updated 19 April 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 reflected the needs for this age group, including text message reminders and the ability to cancel appointments by text.
• Saturday morning appointments were available at a local hub and the practice provided in-house phlebotomy clinics on an appointment basis.

Updated 19 April 2016

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

• The practice had developed templates in Dementia and Mental Health which had been shared across Trafford to improve the quality of the dementia review and to reduce variation. In doing this their prevalence of patients with dementia had increased and performance indicators had improved.

• Mental health performance indicators such as recording alcohol and smoking status for patients with a mental health condition had improved.

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those 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 19 April 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 homeless people, travellers and those with a learning disability.
• The practice demonstrated examples where they had acted to promote the wellbeing of individual patients beyond the commissioned service.
• They identified their most vulnerable patients on their clinical system.
• They offered longer appointments for patients with a learning disability and 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.
• 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.