Lostock Medical Centre

Updated 29 July 2016

Lostock Medical Practice is located on Barton Road in front of Lostock College covering the whole of the Stretford Area and parts of Urmston. There are currently just over 5,000 patients registered and the practice provides services under a General Medical Services (GMS) contract. They are part of Trafford Clinical Commissioning Group. The area has a multi-cultural population and is mid-range on the deprivation scale.

The medical team includes two partners (one male, one female), locum doctors (when required), two practice nurses and a healthcare assistant. They are supported by a practice manager, reception supervisor and a reception/administration team. They are a training practice with three trainee GPs currently. Patients will be seen by the trainee GPs under the supervision of the both partners.

The practice is open at 8am until 6.30pm from Monday to Friday and is closed at the weekend. Appointments are available from 7.30am every morning (by appointment when required) until 11.30am and between 2.30pm and 5.30pm every day except Thursday when appointments finish at 4pm. When the practice is closed patients are directed to the out of hour’s service which is provided by Mastercall. In addition patients have access to a Saturday morning hub and the Trafford Walk in Centre which is open seven days a week between 8am and 8pm.

Updated 29 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Lostock Medical Practice on 28th June 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.
• 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.

The areas where the provider should make improvements are:

• Always have up to date patient group directions (PGDs) and patient specific directions (PSDs) to ensure that nurses and health care assistants administer vaccinations and medicines in line with legislation.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 29 July 2016

The practice is rated as good 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.

• Data for the years 2014/2015 showed that the practice were lower than average for Quality Outcome Framework (QoF) indicators relating to diabetes.The reasons for this was discussed during the inspection. Evidence was provided that a change to the practice clinical system and incorrect coding had been the cause. The practice was able to demonstrate that the issue had been addressed and the data had improved. For example : The percentage of patients on the diabetes register with a record of a foot examination and risk classification within the preceding 12 months had risen from 79% in 2014/2015 to 86% in 2015/2016.

• Weekly chronic disease clinics and longer appointments and home visits were available when needed.

• Rescue packs were available for patients with chronic obstructive pulmonary disease (COPD) and the practice had two Ambulatory Blood Pressure Monitoring(ABPM) monitors to check patients’ blood pressure at home over a 24 hour period.

• 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 29 July 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.

• Staff 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 flexible around school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors, community matrons and sexual health clinics.

• Contraceptive services and cervical-cytology screening were offered by the nurses and the female GP.

Updated 29 July 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.

• Older patients over the age of 75 had a named accountable GP and searches were run once a month so that new patients on the list could be informed of their GP by letter.

• There was good communication with the local pharmacies to provide medication delivery services on a regular basis and at short notice for urgent prescriptions.

• Joint and soft tissue injections and vaginal-pessary fitting and follow up was available.

• Telephone ordering of prescriptions was available for housebound patients.

Updated 29 July 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.

• SMS messaging was used to communicate with patients regarding test results.

• Electronic prescribing, employment medicals and in-house joint and soft-tissue injections were available.

Updated 29 July 2016

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

• Data for 2014/2015 showed that the number of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months was lower than average at 73% compared to the local average of 83% and national average of 84%. Evidence was provided that a change to the practice clinical system and incorrect coding had been the cause. The practice was able to demonstrate that the issue had been addressed and the data had improved. For example the figures for 2015/2016 had increased to 74% and they had a plan to continue the increase.

• 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.

• Data for 2014/2015 showed that the number of patients the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan documented in the record, in the preceding 12 months was 81% compared to the CCG average of 85% and national average of 88%. The practice could demonstrate that this figure had increased and currently stood at 82%.

Updated 29 July 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 homeless people, travellers and those with a learning disability.

• The practice had a close relationship with their local learning-disabilities care home and offered home visits and 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.

• Vulnerable patients were discussed as a standing item on the weekly clinical meetings.