Mesnes View Surgery

Updated 15 June 2016

The practice of Dr Ellis and Kreppel, also known as Mesnes View Surgery, provides primary care services to its registered list of approximately 4300 patients. The practice is situated and the inspection was conducted at Mesnes View Surgery, Mesnes Street, Wigan.

This is a purpose built GP Surgery with disabled access and is located close to Wigan town centre.

There are two partner GPs, both male, and are supported by agency locum GPs when required. They are also supported by a nurse practitioner, practice nurse and a healthcare assistant. There is also in house counselling services available for the patient population. There is a practice manager, business manager and supporting administration, reception and domestic staff.

The male life expectancy for the area is 77 years compared with the CCG averages of 76 years and the National average of 79 years. The female life expectancy for the area is 82 years compared with the CCG averages of 81 years and the national average of 83 years.

The practice delivers commissioned services under the General Medical Services (GMS) contract. It offers direct enhanced services for the childhood vaccination and immunisation scheme, facilitating timely diagnosis and support for people with dementia, influenza and pneumococcal immunisations, improving patient online access, learning disabilities, minor surgery, patient participation, rotavirus and shingles immunisation and unplanned admissions.

The practice is open between 8am and 6pm Monday to Friday with the exception of Wednesday when the practice closes at 1pm. Extended hours are on a Monday until 8.30pm. GP consultation times are Monday, Thursday and Friday 8.40am - 11am and - 3.30pm to 6pm, Tuesday 9am – 11.45am and 3.30pm to 6pm. On a Monday evening GP consultation s are available between 6.30pm and 8.30pm. Telephone consultations take place and home visits are made outside these times.

Patients requiring a GP outside of normal working hours are advised to contact the surgery and they will be directed to the local out of hours service which is provided by Bridgewater NHS Foundation Trust –through NHS 111. Additionally patients can access GP services in the evening and on Saturdays and Sundays through the Wigan GP access alliance at locations across Wigan Borough.

Updated 15 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Ellis and Kreppel (Mesnes View Surgery) on 25 May 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 improvement are:

• Ensure all emergency medicines are kept in one place and all staff are aware of their whereabouts.
• Introduce cleaning checklists to support the cleaning schedules currently in place.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 15 June 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.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and a structured annual review to check their health and medication 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 15 June 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.
• 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.
• In the last five years 81% of patients had received cervical screening compared to the clinical commissioning group (CCG) average of 84% and national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice maintained a register of Looked after Children and Children in Care
• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 15 June 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.
• The practice used the risk stratification toolkit to identify patients with unplanned admissions to hospital and these patients were discussed, following patient consent, at the monthly Integrated Neighbourhood Team meeting (INT). Care plans were completed and reviewed at each meeting or following a further hospital admission.

Updated 15 June 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 offered extended hours appointments on a Monday evening until 8pm.
• The local GP alliance had seven sites across the borough with GP and Nurse appointments outside of normal hours (Monday to Friday 6.30pm-8pm, Saturdays/Sundays/bank holidays from 10am-4pm). This was so patients could access a convenient appointment outside the practices’ opening times.

Updated 15 June 2016

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

• 85% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the CCG (84%) and national (84%) average.
• 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.

Updated 15 June 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 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.