Woodlands Medical Practice

Updated 11 July 2016

Woodlands Medical Practice is located in the centre of the Chadderton area of Oldham. It is a purpose built (in 1977) two storey building with patient access to the ground floor only. There is car parking available. The practice is accessible to patients with mobility difficulties but the practice was looking at ways this could be improved.

The practice has four GP partners and two salaried GPs. Four GPs are male and two female. The practice is a training practice and there is usually as trainee GP at the practice.

In addition to the GPs there is a nurse practitioner, four practice nurses, two healthcare assistants and a phlebotomist. There was a practice manager and several reception and administrative staff. The nurse practitioner and the senior practice nurse are partners in the practice.

At the time of our inspection there were 9540 patients registered with the practice. The practice is overseen by NHS Oldham Clinical Commissioning Group (CCG). The practice delivers commissioned services under a Personal Medical Services (PMS) contract.

The practice has an average patient population with regard to gender and age mix, although here was a slightly higher than average number of patients in the 65 to 69 age group. The practice was in the fifth most deprived decile and life expectancy was around the local and national average. There is a slightly higher than average number of patients with a long term health condition.

There is an out of hours service available provided by a registered provider, Go to Doc.

Updated 11 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Woodlands Medical Practice on 19 May 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. All opportunities for learning from internal and external incidents were maximised.

• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. They had developed a Chadderton research hub that was in its early stages.

• The practice encouraged staff to have other roles. For example, staff had involvement with the clinical commissioning group (CCG) and one partner sat on Oldham Council’s Health and Wellbeing Board.

• Feedback from patients about their care was consistently positive.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. They carried out social prescribing as a way of holistically treating patients’ needs.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from the patient participation group. For example an electronic check in facility had been installed at the reception desk. The PPG also liaised with the local Healthwatch.
• The practice actively reviewed complaints and how they are managed and responded to, and made improvements as a result.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.

We saw two areas of outstanding practice:

• The practice promoted social prescribing as a way of treating patients holistically without necessarily prescribing medicines. This included a bereaved patients being introduced to others to help with social isolation, and help given to a patient with housing needs following the death of a relative.

• The patient participation group (PPG) had been established for 20 years. The practice actively encouraged and valued feedback from patients and the PPG gave examples of recommendations they had made that the practice had acted upon.

  We also saw one area where improvements should be made:

• The practice should ensure carers are identified so appropriate support could be provided. The practice had identified 0.3% of their patients as carers and this was a low amount.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 11 July 2016

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

• Nursing staff worked closely with the GP leads so additional support for patients with complex needs could be offered. A system was in place so that patients usually attended for a review of their long term condition with the greatest need. All other conditions were also reviewed at this appointment to avoid unnecessary duplication.

• Longer appointments and home visits were available when needed, with a failsafe system being in place to manage home visit requests.

• In response to requests from some patients some long term conditions clinics were held early in the morning to make it easier to attend.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Performance for diabetes related indicators was 89.8%. This was better than the local average of 81.8% and in line with the national average of 89.2%.

• 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 11 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 or who did not attend appointments. We saw an example of a safeguarding concern being raised following staff discussion about a child who did not attend an appointment.

• Immunisation rates were higher than average for all standard childhood 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.

• The practice’s uptake for the cervical screening programme was 92.13%, which was higher than the CCG average of 81.94% and the national average of 81.83%. 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. Regular multi-disciplinary team meetings were held and there was a communications book so messages to other healthcare professionals could be left.

Updated 11 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. Home visit requests were well managed.

• Most staff were trained as Dementia Friends.

• Annual health checks were offered to patients over the age of 75.

Updated 11 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.

• The practice was piloting video consultations and was looking at ways to improve these.

• The practice offered early morning appointments for patients who worked. Weekend appointments were also available within the Chadderton hub.

• Telephone consultations were available and the times of these could be flexible for patients who worked.

• NHS health checks were offered to patients over the age of 40.

Updated 11 July 2016

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

• Most staff were trained as Dementia friends and there was a Dementia Champion.

• Performance for mental health related indicators was 100%. This was better than the local average of 91.7% and the national average of 92.8%.

• 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.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 11 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 those with a learning disability.

• 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 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.