Five Oaks Family Practice

Updated 6 June 2016

Five Oaks Family Practice is located on the outskirts of Manchester city centre and is overseen by North Manchester Clinical Commissioning Group (CCG).

The practice has been established since 1962. Since then Five Oaks with a long history of innovation, for example :

• First practice to be fully computerised in 1989

• Audit advisors for Greater Manchester in 1990

• Fundholding in 1996

• Investors in people award in 2000

• Paperless accreditation in 2010

• Led and set up GP Federation in 2014

The practice is a large purpose built building which has a first floor. The building was designed to extend a further level required. The ground floor has full disabled entrance access with a large seated reception area. The GP consulting rooms are all located on the ground floor. The first floor has access by stairs or lift, where staff offices are located. There is a disabled toilet on the ground floor, which has baby changing facilities. All staffing areas are closed off to the public with a key pad entry system.

The practice offers the use of their function room to the community, which can be used for education training session, meetings for the CCG and it also holds the practice managers forum group. The practice also houses the local medical council (LMC) offices and GP federation headquarters.

The practice has three GP partners and three salaried GPs with a GP trainee (six males and one female) with two practice nurses and one assistant practitioner. Members of clinical staff are supported by one practice manager and one IT manager with reception/ administrative staff.

The practice is open from 8am until 6.30 pm Monday, Tuesday, Thursday and Friday. Wednesdays are open from 8 am till 1 pm, the patients are transferred to “ Go-to- Doc” between 1pm and 6pm. Appointments times are between 8.30am and 6pm. The practice also dedicated GPs appointments on Sunday which were for carer only.

The practice has a Personal Medical Service (PMS) contract with NHS England. At the time of our inspection in total 8950 patients were registered.

The practice is in a highly deprived area of Manchester, and treats a varied ethnically diverse population group. The practice treats a high number of new immigrants arriving into Manchester.

Patients requiring a GP outside of normal working hours are advised to call NHS111,        “ Go-to- Doc” using the usual surgery number and the call is re-directed to the out-of-hours service. The surgery is part of Prime Ministers GP Access (GPPO) scheme offering extended hours and weekend appointments to patients.

Updated 6 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Five Oaks Family Practice on 5 April 2016. Overall the practice is rated as outstanding.

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

• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, initiating and leading the scheme which provides a seven day service in Manchester to patients.
• All staff fully understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised and transparent. With strong and visible clinical and managerial leadership and governance arrangements.
• The practice had a clear vision which had quality and safety as its top priority with good facilities and was well equipped to treat patients and meet their needs such as, ensuring the practice was meeting Disability Discrimination Act (DDA) standards.
• The practice engaged effectively with local community groups and charities to improve community services and patient access, working with local groups around long term conditions and community wider issues. Feedback from patients about their care was consistently positive with many examples of the practice’s caring nature.

We saw one of outstanding practice, showing innovation and leading on the new initiatives for the local community and patients:

• The practice had identified that a large number of their patients suffered with long term conditions. In view of this they formed a partnership with the Expert Patients Group based at Manchester University. The Expert Patients Programme supports people with long-term conditions to regain as much control over their physical and emotional well-being as possible. The Practice facilitated this programme to run on their premises for ease of access for their patients. An example of the success of this programme was that the practice identified a cost saving in just one patient between 2012-2015 of £850,000 whilst reducing the attendance to the Accident and Emergency department and GP emergency appointments from 27 down to five (over 14 weeks).

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 6 June 2016

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

• The practice identified a large number of patients with long term conditions and formed a partnership with the Expert Patients Group. The programme supported patients with long-term conditions to regain as much control over their physical and emotional well-being as possible.
• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• 99.7% of patients with diabetes, on the register, who have had influenza immunisation in the preceding August to March 2015 (01/04/2014 to 31/03/2015), higher than national average of 94%.
• 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.

Updated 6 June 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.
• The practice’s uptake for the cervical screening programme was 80.7%, which was above the national average of 74%.
• 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 6 June 2016

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

• The practice had a low number of older patients.
• The practice provided sole primary care for a local residential nursing home, offering six monthly reviews, and monthly clinic rounds with dedicated clinical and non-clinical staff to support the patients.
• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice offered proactive, personalised care to meet the needs of the older people in its population.

Updated 6 June 2016

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

• The practice had dedicated Sunday appointments for all working carers.
• The practice offered and hosted multiple services for patients; we were given example of a GP staying behind in clinic to accommodate a patient who was unable to leave work early.
• 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.
• The Well Woman clinic was held on a Thursday evening to enable as many employed staff to attend as possible.

Updated 6 June 2016

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

• 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. We saw benchmarked data where the practice identified and supported patients to reduce hospital and GP attendance.
• 94.3% of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months (01/04/2014 to 31/03/2015). This was higher than the national average of 84.4%.
• The practice supported a residential care home supporting patients with advanced and complicated mental health issues, the practice ensured very close working relationships between the care staff and management team, whilst providing continuity of care and support for patients over the last 10 years.
• The practice regularly worked with care managers, disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

Updated 6 June 2016

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

• The practice developed an extra in-house register for patients who the practice identified as needing extra support or risk of being vulnerable.
• 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.