The Village Medical Practice

Updated 26 October 2017

The Village Medical Practice, Crompton Health Centre, High Street, Shaw, Oldham, OL2 8ST provides primary medical services in Oldham from Monday to Friday.

The practice is now part of Hope Citadel Healthcare who provide primary care services in other practices in the Greater Manchester area. The practice benefits from high level support and leadership from the provider as well as access to human resources.

The surgery is open :

Monday to Friday 8am to 6.30pm.

The Village Medical Practice is situated within the geographical area of Oldham Commissioning Group (CCG).

The practice has an Alternative Provider Medical Services (APMS) contract. The APMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.

The Village Medical Practice is responsible for providing care to 3119 patients.

The practice consists of one female GP and is supported by a female advanced nurse practitioner, a focused care worker, practice nurse and health care assistant. The practice is supported by a patient services manager and an administration team that includes receptionists.

The provider was in the process of recruiting an additional nurse.

When the practice is closed patients are told to ring 111 which is the out of hour’s service provided by NHS 111.

The practice belongs to a group of local practices who provide access to a GP and practice nurse at evenings and weekends.

Updated 26 October 2017

Letter from the Chief Inspector of General Practice

The Village Medical Practice was acquired by Hope Citadel Healthcare in October 2016. We carried out an announced comprehensive inspection on 27 September 2017. 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 a system in place for reporting and recording significant events.
• The practice had clearly defined systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available.
• All staff employed by the practice had received a disclosure and barring check (DBS check). (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable).
• Patients we spoke with 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.
• Although the practice had some good facilities and was well equipped to treat patients and meet their needs the practice occupied a small area within a health centre which they shared with another practice. They had very little office and storage space and four treatment rooms which were used by GPs, advanced nurse practitioner, focused care workers, counsellors, practice nurse and health care assistants.
• Due to the space restrictions the practice were unable to offer services offered at other Hope Citadel practices for example social activities such as craft classes for female patients, gardening classes for male patients and boogie babies.
• 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 the requirements of the duty of candour.

We saw one area of outstanding practice:

The practice recruited focused care workers who were able to provide social and medical care for patients in need. They were able to demonstrate the positive impact for this group of patients. For example one patient asked to speak to us and told us of their personal experience of how the practice had made a positive difference to their life.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 26 October 2017

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

• Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.
• Data from the Quality and Outcomes Framework was unavailable for this new provider as the practice had been acquired in October 2016, published data would not be available until late 2018. However, they were able to show us that 91% of diabetic patients had a record of having had a foot examination and risk classification within the preceding twelve months compared to the national average of 87%.
• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.
• There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health.
• All these patients had a named GP and there was a system to recall patients for 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 26 October 2017

The practice is rated as good for the care of families, children and young people.

• From the sample of documented examples we reviewed we found there were systems 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 accident and emergency (A&E) attendances.
• Immunisation rates were relatively high for all standard childhood immunisations.
• The practice provided support for premature babies and their families following discharge from hospital.
• Care plans were in place for complex families and the practice worked closely with other agencies to resolve issues such as substance abuse, housing, debt, domestic violence and mental health. The practice were able to give us examples of positive outcomes for this group of patients.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice worked with midwives, health visitors and school nurses to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.
• The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications.
• Young people were offered sexual health screening and contraception advice.

Updated 26 October 2017

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

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.
• The practice offered proactive, personalised care to meet the needs of the older patients in its population.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• All patients over the age of 65 were offered nurse led assessments and those considered at risk were offered a follow up appointment with a GP.
• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.
• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.
• Where older patients had complex needs, the practice shared summary care records with local care services.
• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible
• The lead GP for the practice carried out a weekly visit to care homes to discuss patient care with staff. Care plans were updated and any patients that were highlighted by staff were seen by the GP. A general walk round was also carried out.
• The practice linked with Age UK who attended the monthly GSF multi-disciplinary palliative care meetings.

Updated 26 October 2017

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

• The needs of these populations had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care, for example, extended opening hours were offered by the Oldham Integrated Care Centre.
• 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 focussed care worker assisted families with housing issues and the completion of documentation.

Updated 26 October 2017

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

• The practice carried out advance care planning for patients living with dementia.
• The practice told us that 26% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is below the national average. We were told that the recently recruited lead GP was now actively working on improving these figures.
• The lead GP was carrying out a full review of dementia care within the practice.
• The practice specifically considered the physical health needs of patients with poor mental health and dementia.
• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.
• The practice told us that 63% of patients suffering from poor mental health had an agreed care plan in place. We were told that the lead GP was actively working on improving these figures.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• Patients at risk of dementia were identified and offered an assessment.
• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.
• Patients were able to self refer to see an in house MIND counsellor who was able to make a prompt assessment and refer to other services or see the patient weekly, whichever was most appropriate.
• The practice employed a counsellor who would see patients with more complicated needs and offer an agreed a care plan with the patient.
• The focused care worker was able to arrange to see patients at home who had difficulty engaging with the mental health services.
• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia.

Updated 26 October 2017

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, those with a learning disability, asylum seekers and those suffering from substance abuse.
• The practice staff included a focused care worker who provided social and medical care to its patients in need of this support. The practice were able to provide examples where they had assisted patients experiencing difficult circumstances.
• Translators were available for patients whose first language was not English.
• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.
• 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 had information available for vulnerable patients about how to access various support groups and voluntary organisations.
• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.