Prenton Medical Centre

Updated 20 June 2017

Prenton Medical Centre is registered with the Care Quality Commission to provide primary care services. The practice provides GP services for approximately 2000 patients living in Wirral and is situated in a converted residential dwelling. The practice has one female GP, two male GPs, a practice nurse, administration and reception staff and a practice management team. Prenton Medical Centre holds a General Medical Services (GMS) contract with NHS England.

The practice is open Mondays and Tuesdays 8am -1pm, 2pm – 6.30pm, Wednesday 8am – 1pm, 2pm – 5pm, Thursday 8am – 1pm, 2pm – 8pm, Friday 8am – 1pm, 2pm – 6.30pm. The practice will also provide appointments on a Saturday and Sunday morning as required by patients at a sister practice nearby. Patients can book appointments in person, via the telephone or online. The practice provides telephone consultations, pre-bookable consultations, on the day walk in appointments, 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 Wirral Clinical Commissioning Group (CCG) and is situated in a more affluent area. The practice population is made up of around national average population groups with 20% of the population under 18 years old and 22% of the population aged over 65 years old (above national average).

The practice does not provide out of hours services. When the surgery is closed patients are directed to the GP out of hour’s service provider (NHS 111). Information regarding out of hours services was displayed on the website and in the practice information leaflet.

Updated 20 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Prenton Medical Centre on16 May 2017. Overall the practice is rated as good.

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

• There were systems in place to mitigate safety risks including analysing significant events and safeguarding.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Patients’ needs were assessed and care was planned and delivered in line with current legislation.
• Patients said they were treated with care, compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and feedback.
• Patients we spoke with said they found it easy to make an appointment with a named GP and there was continuity of care. Routine and urgent appointments were available the same day with an open access surgery in the mornings.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice had arrangements to respond to emergencies and major incidents.
• There was a clear leadership structure and staff felt supported by management. The practice sought patient views about improvements that could be made to the service; including having a patient participation group (PPG) and acted, where possible, on feedback.
• Staff worked well together as a team, knew their patients well and all felt supported to carry out their roles.
• The provider was aware of the requirements of the duty of candour.

There were areas where the provider should make improvements and these are:

• Review the recruitment records to ensure all required information relating to people working at the practice was obtained and held.

• Review the chaperone policy to ensure all staff who had been trained to undertake these duties had also been checked through the Disclosure and Barring Service (DBS).

• Review policies and procedures to ensure they are specific to the practice with local contact details.

• Review protocols and staff training to ensure correct procedures are followed if the fridge temperatures fall outside of the required range for temperature sensitive medicines to minimise the risk of adverse effects on the medicines.

• Review the systems to monitor the use of prescription pads.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 20 June 2017

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

• The practice nurse specialised in long-term/chronic disease management and patients at risk of hospital admission were identified as a priority. As part of this they provided regular, structured reviews of patients’ health.

• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.

• There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health.

• The practice held information about the prevalence of specific long term conditions within its patient population. This included conditions such as diabetes, chronic obstructive pulmonary disease (COPD), cardio vascular disease and hypertension. The information was used to target service provision, for example to ensure patients who required regular checks received these.

• All these patients had a named GP and there was a system to recall patients for 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.

• The practice held regular multi-disciplinary meetings to discuss patients with complex needs and patients receiving end of life care.

• Longer appointments and home visits were available for patients with long term conditions when these were required.

• Patients with multiple long term conditions could be offered a single appointment to avoid multiple visits to the surgery.

Updated 20 June 2017

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

• From the sample of documented examples we reviewed we found there were systems 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 accident and emergency (A&E) attendances.

• Patients told us, on the day of inspection, that 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.

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

• The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications.

Updated 20 June 2017

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

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.

• The practice offered proactive, personalised care to meet the needs of the older patients in its population.

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.

• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.

• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible. For example, carrying out over 75’s health checks, fall prevention assessments and Flu vaccinations for the elderly.

Updated 20 June 2017

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

• The needs of these populations had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care, for example, telephone consultations, extended opening hours with Saturday and Sunday appointments available.

• 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 20 June 2017

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

• The practice held a register of patients experiencing poor mental health.

• The practice specifically considered the physical health needs of patients with poor mental health and dementia.

• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.

• Patients at risk of dementia were identified and offered an assessment.

• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.

• The practice had a system to follow up patients who had attended accident and emergency departments where they may have been experiencing poor mental health.

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

Updated 20 June 2017

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.

• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.

• 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 had information available for vulnerable patients about how to access various support groups and voluntary organisations.

• Staff interviewed 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.