Archived: Irlam Clinic

Updated 1 October 2015

Irlam Clinic is GP surgery is situated in the Irlam area of Salford. Irlam Clinic is one of two GP practices in Salford operated by Cornerstone Medical Practice. At the time of this inspection we were informed 2,950 patients were registered with Irlam Clinic.

The practice population experiences similar levels of income deprivation than the practice average across England. There is a higher proportion of patients above 65 years of age (17.7%) than the practice average across England (16.7%). The practice has a similar proportion of patients under 18 years of age (15.2%) than the practice average across England (14.8%). 59.2 per cent of the practice’s patients have a longstanding medical condition compared to the practice average across England of 54%.

At the time of our inspection two salaried GPs were providing primary medical services to patients registered at the practice supported by a partner GP (who also works at a separate practice operated by Cornerstone Medical Practice). The GPs were supported in providing clinical services by a practice nurse and an assistant practitioner. Clinical staff were supported by the practice manager and the other members of the practice team.

The opening times of the practice were 8am to 6.30pm Monday to Friday. Appointment times were 9am to 11am and 3.30pm to 5.30pm Monday to Friday. The practice has opted out of providing out-of-hours services to their patients. In case of a medical emergency outside normal surgery hours advice was provided by NHS 111. They would then arrange for the out of hours GP service to see patients if required. The practice website and patient information leaflet available at the practice details how to access medical advice when the practice is closed. Patients are also provided with these details via a recorded message when they telephone the practice outside the usual opening times.

The practice contracts with NHS England to provide Personal Medical Services (PMS) to the patients registered with the practice.

We noted that there had been changes in the management structure that has implications for the provider’s Care Quality Commission (CQC) registration. In particular one of the GP partners named on the provider’s registration has left the partnership. This person had also been approved by CQC as the registered manager for Irlam Clinic. We advised the provider about the need to take action to make the relevant applications to ensure their CQC registration is up to date.

Updated 1 October 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Irlam Clinic on 3 September 2015. 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 to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• Patients told us that they found it easy to make an appointment with a named GP and that 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.

However there was one area of practice where the provider should make improvements:

The practice had a system in place for handling complaints and concerns. However the information to people should be updated to advise them how to pursue their complaint if dis-satisfied with the response provided by the practice.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 1 October 2015

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. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 1 October 2015

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. 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. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 1 October 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 1 October 2015

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.

Updated 1 October 2015

The practice had carried out annual health checks for people experiencing poor mental health. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health including those with dementia. The practice had sign-posted patients experiencing poor mental health to various support groups and third sector organisations such as MIND. There was a system in place to follow up on patients who did not attend practice appointments or had attended accident and emergency where there may have been mental health needs.

Updated 1 October 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. It had carried out annual health checks for people with a learning disability. It offered longer appointments for people with a learning disability. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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.