Great Harwood Medical Group

Updated 22 September 2016

Great Harwood Medical Group is a member of the East Lancashire Clinical Commissioning Group (CCG). Personal Medical Services (PMS) are provided under a contract with NHS England.

The surgery occupies a location on the first floor of purpose built health facility. The building is well designed and spacious with good facilities for those with limited mobility. The practice offers a comprehensive range of services including minor surgery. There is also a branch surgery based at Rishton approximately two miles away.

The practice is located in an area of high deprivation in Great Harwood on the outskirts of Blackburn, Lancashire. Information published by Public Health England rates the level of deprivation within the practice population group as four on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

The practice currently has a patient list size of 8,391. The average life expectancy of the practice population comparable with both CCG and national averages for males at 78 years (compared to CCG 77 years and national average 79 years). Life expectancy for females is also comparable with CCG and national averages at 82 years (CCG 81 years and national average 83 years). Age groups and population groups within the practice population are comparable with CCG and national averages.

There are four GPs (two female and two male, three of whom are partners), who work at the practice. The practice is also a training practice for future GPs. Nursing staff consist of a practice nurse and a health care assistant; all of whom are female. There is a practice manager, and a team of reception and administrative staff who oversee the day to day running of the practice.

The practice is open Monday to Friday 8am to 6.30pm. In addition to pre-bookable appointments that could be booked up to six weeks in advance, the practice has two sessions each day where urgent appointments are available in their ‘sit and wait’ sessions.

When the practice is closed out of hours services are provided by East Lancashire Medical Services and can be contacted by telephoning NHS 111.

Updated 22 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Great Harwood Medical Group on 1 September 2016. Overall the practice is rated as good for providing safe, effective, caring, responsive and well-led care for all of the population groups it serves.

Our key findings across all the areas we inspected were as follows:

• The practice staff had a very good understanding of the needs of their practice population and was flexible in their service delivery to meet patient demands; such as providing flexible GP appointments when required.
• There was a clear leadership structure, staff were aware of their roles and responsibilities and told us the GPs were accessible and supportive.
• There was evidence of an all-inclusive team approach to providing services and care for patients.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients’ needs were assessed and care was planned and delivered following local and national care pathways and National Institute for Health and Care Excellence (NICE) guidance.
• The practice promoted a culture of openness and honesty. There was a nominated lead for dealing with complaints and significant events.
• All staff were encouraged and supported to record any incidents using the electronic reporting system. There was evidence of good investigation, learning and sharing mechanisms in place.
• Risks to patients were assessed and well managed.
• There was a safeguarding lead in place and robust systems to protect patients and staff from abuse.
• The practice sought patient views how improvements could be made to the service, through the use of patient surveys, the NHS Friends and Family Test and engagement with patients and their local community.
• The practice complied with the requirements of the duty of candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment.)

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 September 2016

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

• The practice nurse had lead roles in the management of long term conditions, supported by the GPs. Annual reviews were undertaken to check patients’ health care and treatment needs were being met.

• The practice maintained a register of patients who were a high risk of an unplanned hospital admission. Care plans and support were in place for these patients.

• The practice had a same day access policy for those patients who experienced deterioration in their condition. Longer appointments were also available as needed.

• In house phlebotomy services were provided.

• 90% of patients diagnosed with chronic obstructive pulmonary disease (COPD) had received a review in the last 12 months, in line with 90% both locally and nationally.

Updated 22 September 2016

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

• The practice worked with midwives, health visitors and school nurses to support the needs of this population group. For example, the provision, ante-natal, post-natal and child health surveillance clinics.

• 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. A dedicated vaccination recall lead was in place to ensure children who did not attend vaccination appointments were followed up.

• Patients and staff told us children and young people were treated in an age-appropriate way and were recognised as individuals.

• Appointments were available outside of school hours and the premises were suitable for children and babies. Same day access was available for all children under the age of five.

• Sexual health, contraceptive and cervical screening services were provided at the practice.

• 80% of eligible patients had received cervical screening, compared to 82% both locally and nationally.

• Two female GPs provide contraception services for the practice and other practice’s patients in the local area.

Updated 22 September 2016

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

• Proactive, responsive care was provided to meet the needs of the older people in its population.

• The practice worked closely with dedicated community matron who co-ordinated care for patients over 75.

• Registers of patients who were aged 75 and above and also the frail elderly were in place to ensure timely care and support were provided. Health checks were offered for all these patients.

• Immunisation and phlebotomy services were provided for house bound patients.

• The practice worked closely with other health and social care professionals, via the local integrated neighbourhood team, involving continued liaison with multi-disciplinary care teams. This was to help housebound patients received co-ordinated care and support and reduce hospital admissions.

Updated 22 September 2016

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

• The needs of these patients 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 provided telephone and email consultations, online booking of appointments and ordering of prescriptions.
• Late appointments were offered during the week and the nursing hours had been increased to provide additional support in the early morning.
• The practice offered a range of health promotion and screening that reflected the needs for this age group.
• Health checks were offered to patients aged between 40 and 74 who did not have a pre-existing condition.
• Travel health advice and vaccinations were available.

Updated 22 September 2016

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

• Patients and/or their carer were given information on how to access various support groups and voluntary organisations.

• 86% of patients diagnosed with dementia had received a face to face review of their care in the last 12 months, compared to 82% locally and 84% nationally.

• Staff have ‘dementia friends’ training and PPG had held a dementia befriending event.

• The practice had developed comprehensive care plans for patients with dementia.

• 97% of patients who had a severe mental health problem had received an annual review in the past 12 months and had a comprehensive, agreed care plan documented in their record. This was comparable to the local 88% and national average of 89%.

• The practice held a ‘minds matter’ support group weekly.

• Same day appointments / phone consultation were made for patients experiencing poor mental health.

Updated 22 September 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• Staff 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.

• We saw there was information available on how patients could access various local support groups and voluntary organisations.

• Annual reviews for patients with a learning disability were provided where the patient preferred for example at their home or at the practice.

• The practice supported patients with alcohol and drug dependencies and worked in close liaison with a local integrated substance misuse service.