Heath Lane Medical Centre

Updated 10 June 2016

Heath Lane Medical Centre is responsible for providing primary care services to approximately 7,300 patients. The practice is based in an area with lower than average levels of economic deprivation when compared to other practices nationally. The number of patients with a long standing health condition is about average when compared to other practices nationally.

The staff team includes two partner GPs, three salaried GPs, two advanced nurse practitioners, two practice nurses, two health care assistants, a phlebotomist, practice manager and administration and reception staff.

The practice is open 08:00 to 18.30 Monday to Friday. An extended hour’s service for routine appointments and an out of hour’s service are commissioned by West Cheshire CCG and provided by Cheshire and Wirral Partnership NHS Foundation Trust.

The practice has a General Medical Service (GMS) contract. the practice offers a range of enhanced services such as flu and shingles vaccinations, minor surgery and timely diagnosis of dementia.

Updated 10 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Heath lane Medical Centre on 13th April 2016.

Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Staff were aware of procedures for safeguarding patients from the risk of abuse.
• There were systems in place to reduce risks to patient safety, for example, infection control procedures and the management of staffing levels. Improvements should be made to the management of blood test results and to the records of staff recruitment and significant events.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.

• Staff felt well supported. They had access to training and development opportunities and had received training appropriate to their roles.

• Patients generally said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment. We saw staff treated patients with kindness and respect.

• Services were planned and delivered to take into account the needs of different patient groups.

• Access to the service was monitored to ensure it met the needs of patients.

• Information about how to complain was available. There was a system in place to manage complaints.

• There were systems in place to monitor and improve quality and identify risk.

The areas where the provider should make improvements are:

• All blood test results should be reviewed by a clinician with access to the medical record and the training to understand the significance of the result.

• Document reviews of significant events to demonstrate that actions identified have been implemented.

• Ensure that there is a record of the required recruitment information to confirm the suitability of staff employed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 June 2016

The practice is rated as good for the care of people with long-term conditions. The practice held information about the prevalence of specific long term conditions within its patient population such as diabetes, chronic obstructive pulmonary disease (COPD), cardio vascular disease and hypertension. This information was reflected in the services provided, for example, reviews of conditions and treatment, screening programmes and vaccination programmes. The practice had a system in place to make sure no patient missed their regular reviews for long term conditions. The clinical staff took the lead for different long term conditions and kept up to date in their specialist areas. The practice had multi-disciplinary meetings to discuss the needs of palliative care patients and patients with complex needs. The practice worked with other agencies and health providers to provide support and access specialist help when needed. The practice referred patients who were over 18 and with long term health conditions to a well-being co-ordinator for support with social issues that were having a detrimental impact upon their lives. Mail shots were sent to patients advising them about education and self-help services that were available to support them to manage their long term conditions. A patient hub was in the process of being set-up next to the waiting area. This would contain equipment for the self-monitoring of health conditions, useful information for patients about community health and social care services and would be a base for community services to provide face to face information to patients visiting the practice.

Updated 10 June 2016

The practice is rated as good for the care of families, children and young people. Child health surveillance and immunisation clinics were provided. The staff we spoke with had appropriate knowledge about child protection and all staff had safeguarding training relevant to their role. The safeguarding lead staff liaised with school health, midwives and health visiting colleagues to discuss any concerns about children and how they could be best supported. Electronic software that could be downloaded to mobile devices had been developed to encourage younger patients to review and access the services offered by the practice. Two sixth form students had recently become members of the Patient Participation Group (PPG) which would enable the views of younger patients to be considered.

Updated 10 June 2016

The practice is rated as good for the care of older people. The practice was knowledgeable about the number and health needs of older patients using the service. They kept up to date registers of patients’ health conditions and used this information to plan reviews of health care and to offer services such as vaccinations for flu and shingles. The practice had identified patients with high accident and emergency attendance and a care plan had been developed to support them. This included having a named clinician to promote continuity of care. These patients also had access to a telephone number to enable quicker access to clinical staff. The practice worked with other agencies and health providers to provide support and access specialist help when needed. Multi-disciplinary meetings were held to discuss and plan for the care of frail and elderly patients. The practice was working with neighbourhood practices and the CCG to provide services to meet the needs of older people. They had implemented a pilot project whereby a practice nurse visited frail older housebound patients to provide reviews of care and assessments following discharge from hospital after an unplanned admission.

Updated 10 June 2016

The practice is rated as good for the care of working-age people (including those recently retired and students). The practice offered pre-bookable appointments, book on the day appointments and telephone consultations. Patients could book appointments on-line or via the telephone and repeat prescriptions could be ordered on-line which provided flexibility to working patients and those in full time education. Electronic software that could be downloaded to mobile devices had been introduced to provide further access. The practice was open from 08:00 to 18:30 Monday to Friday allowing early morning and late evening appointments to be offered to this group of patients. An extended hour’s service for routine appointments was commissioned by West Cheshire CCG. The practice website provided information around self-care and local services available for patients. The practice offered health checks to patients aged 40 – 74 which included cholesterol and blood glucose checks to help identify potential health risks.

Updated 10 June 2016

The practice is rated good for the care of people experiencing poor mental health (including people with dementia). GPs worked with specialist services to review care and to ensure patients received the support they needed. The practice had a policy in place for following up any patient who did not attend their mental health appointments.  The practice maintained a register of patients who experienced poor mental health. The register supported clinical staff to offer patients experiencing poor mental health, including dementia, an annual health check and a medication review. The practice referred patients to appropriate services such as psychiatry and counselling services. Counsellors were based at the practice which enabled patients to be seen in their own surgery and facilitated good communication and liaison between the community and practice team. The practice had information in the waiting areas about services available for patients with poor mental health. For example, services for patients who may experience depression. Clinical and non-clinical staff had undertaken training in dementia to ensure all were able to appropriately support patients.

Updated 10 June 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable. Patients’ electronic records contained alerts for staff regarding patients requiring additional assistance. For example, if a patient had a learning disability to enable appropriate support to be provided. There was a recall system to ensure patients with a learning disability received an annual health check. The staff we spoke with had appropriate knowledge about safeguarding vulnerable adults and all staff had safeguarding training relevant to their role. Se rvices for carers were publicised and a record was kept of carers to ensure they had access to appropriate services. A member of staff was the carer’s link. A representative from the Carers Trust visited the practice and provided information for patients about the services provided. The practice referred patients to local health and social care services for support, such as drug and alcohol services and to the wellbeing coordinator.