Archived: Belle Vale Medical Practice

Updated 28 May 2015

Belle Vale Medical Practice is registered with the Care Quality Commission to provide primary care services. It provides GP services for approximately 7500 patients living in Liverpool. The practice has six GPs (two male and four female), a practice manager, practice nurses, administration and reception staff. Belle Vale Medical Practice holds a Personal Medical Services (PMS) contract with NHS England.

The practice is open during the week; between 8.00am and 6.30pm. Patients can book appointments in person, online or via the telephone. The practice provides telephone consultations, pre bookable consultations, urgent consultations and home visits. The practice treats patients of all ages and provides a range of primary medical services.

The practice is part of Liverpool Clinical Commissioning Group (CCG).The practice is situated in an area with high deprivation. The practice population is made up of a slightly higher than national average working age population. Sixty three percent of the patient population has a long standing health condition, whilst 51% have health related problems in daily life. There is a slightly lower than national average number of unemployed.

The Out-of-Hours GP service is provided by Urgent Care 24 (UC24).

Updated 28 May 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Belle Vale Medical Practice on 28 April 2015. Overall the practice is rated as good.

Belle Vale Medical Practice provided safe, effective, responsive care that was well led and addressed the needs of the population it served. The service was caring and compassionate and patients spoke highly of it.

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

• Systems were in place to ensure incidents and significant events were identified, investigated and reported. Staff understood and carried out their responsibilities to raise concerns and report incidents and near misses. Lessons learnt from the investigation of safety incidents were disseminated to staff. Infection risks and medicines were managed safely.

• People’s needs were assessed and care was planned and delivered in line with current legislation and guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned. Patients experienced clinical outcomes that were in line with or above the national average.

• Patients said they were treated with care, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.

• The practice provided good care to its population that was responsive to their health needs. Patients were listened to and feedback was acted upon. Complaints were managed appropriately. Patients said the on line booking system had improved access to appointments. Most patients were satisfied with the opening hours, continuity of care and availability of appointments.

• There was a clear leadership structure, staff enjoyed working for the practice and felt well supported and valued. The practice monitored, evaluated and improved services. The practice proactively sought feedback from staff and patients, which it acted on. There was an active patient participation group.

There were areas of practice where the provider needs to make improvements.

The provider should:

• Ensure its recruitment arrangements are in line with Schedule 3 of the Health and Social Care Act 2008 to ensure necessary employment checks are in place for all staff and the required information in respect of workers is held. This should include obtaining information about any physical or mental health conditions which are relevant to the person’s role.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 May 2015

The practice is rated as good for the care of people with long-term conditions. The practice had a higher than national average number of patients with long standing health conditions (63% of its population). Patients with long term conditions were supported by a healthcare team that cared for them using good practice guidelines and were attentive to their changing needs. There was proactive intervention for patients with long term conditions. Patients had health reviews at regular intervals depending on their health needs and condition. The practice had engaged with Telehealth UK to promote self-care and management of conditions and to reduce unplanned hospital admissions. Telehealth is the remote exchange of data between a patient at home and their clinician(s) to assist in diagnosis and monitoring typically used to support patients with Long Term Conditions. Among other things it comprises of fixed or mobile home units to measure and monitor temperatures, blood pressure and other vital signs parameters for clinical review at a remote location using phone lines or wireless technology

The practice maintained and monitored registers of patients with long term conditions for example cardiovascular disease, diabetes, chronic obstructive pulmonary disease, asthma and heart failure. These registers enabled the practice to monitor and review patients with long term conditions effectively. The Quality and Outcomes Framework (QOF) information indicated that patients with long term health conditions received care and treatment as expected and above the national average. For example, patients with diabetes had regular screening and monitoring, clinical risk groups (at risk due to long term conditions) had good uptake rates for seasonal flu vaccinations and patients with long term conditions had regular reviews of their health and medication.

Clinical staff managed chronic long term conditions and diseases. Patients at risk of hospital admission were identified as a priority. Longer appointments (for example 30 minute appointments) and home visits were available when needed. 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 social care professionals to deliver a multidisciplinary package of care.

Updated 28 May 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, the practice maintained a register of children who had a child protection plan. Immunisation rates were around average for all standard childhood immunisations. Appointments were available outside of school hours and the premises were suitable for children and babies including breast feeding and baby changing rooms. We saw good examples of joint working with midwives, health visitors and school nurses. For example there were weekly health visitor clinics held at the practice.

The practice responded to the needs of this group well and children or young people were always given a same day appointment or urgent appointment as necessary. The practice safeguarding lead worked with the health visitor safeguarding lead to identify, discuss and care for children at risk.

Updated 28 May 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. For example the Quality and Outcomes Framework (QOF) information indicated that last year 78% of patients aged 65 and older had received a seasonal flu vaccination. This was higher than the national average. 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, avoiding unplanned admissions, seasonal flu vaccinations and in dementia and end of life care. It was responsive to the needs of older people, and offered home visits, rapid access and extended appointments for those with enhanced needs.

The practice safeguarded older vulnerable patients from the risk of harm or abuse. There were policies in place, staff had been trained and were knowledgeable regarding vulnerable older people and how to safeguard them.

Updated 28 May 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 offered flexibility in appointments with telephone consultations, online booking and other online services available for this group of patients. They provided a range of services such as health promotion and screening that reflected the needs for this age group, for example smoking cessation and travel advice. Routine health checks were available to patients aged over 40.

Updated 28 May 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). They held registers of patients experiencing poor mental health which helped them plan deliver and review care appropriately. One hundred percent of people experiencing poor mental health had an agreed documented care plan and 95% of those diagnosed with dementia had received a review of their care in the preceding 12 months. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia.

The practice worked closely with the mental health services in Liverpool. The practice was able to signpost patients experiencing poor mental health to access various support groups and voluntary organisations including MIND and referred patients to the local memory clinic where appropriate. Patients with poor mental health were accommodated, where possible, with same day appointments with a preferred clinician. Home visits were made to accommodate patients who were not mentally well enough to attend the practice. Some of the staff had received training on how to care for people with mental health needs and dementia.

Updated 28 May 2015

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, children and adults at risk of abuse, patients with dementia, terminally ill and those with a learning disability. It had carried out annual health checks for people with a learning disability and it offered longer appointments (30 minutes) for vulnerable patients. The practice contacted patients who had been discharged from hospital following an unplanned admission within 72 hours of their discharge.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It was able to signpost vulnerable patients and their carers to various support groups and voluntary organisations. Staff knew how to recognise signs of abuse in vulnerable adults and children.