Belle Vale Medical Practice

Updated 25 May 2017

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 is managed by two GP partners (female) and has four salaried GPs. There is a nurse practitioner, practice nurses and a health care support worker. There is a practice manager and administration and reception staff. Belle Vale Medical Practice holds a General Medical Services (GMS) contract with NHS England.

The practice is open during the week; between 8am 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.

Patients accessed the Out-of-Hours GP service by calling NHS 111.

Updated 25 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Belle Vale Medical Practice on 28 April 2017. Overall the practice is rated as good.

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

• Belle Vale Medical Practice is situated in a health centre shared with other community clinics. There is disabled access, a hearing loop and translation facilities.
• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• 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 we spoke with and Care Quality Commission (CQC) comment cards reviewed indicated that patients were treated with 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 concerns.
• Patients we spoke with said they found it easy to make an appointment but not necessarily with a named GP of their choice. Urgent appointments were available the same day.
• 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 the requirements of the duty of candour.

We saw an area of outstanding practice:

The practice engaged well with the patient participation group (PPG) and actively sought engagement within local community groups and their patients. For example,

• The practice hosted carer forum meetings for carers from their practice and other practices within the locality.
• The practice manger and chair of the PPG had attended a local school to gain the views of teenagers as to what medical services they required. Teenagers involved had helped produce a newsletter for the practice to highlight areas of importance to this population group.
• One of the GPs attended a primary school to give educational sessions regarding healthy lifestyles.

• The practice designed their own information leaflets and used humorous poetry to convey messages. For example, they designed a leaflet intended for the over 75s with useful contact numbers, information about obesity and information about cancer screening.
• Over the past 12 months the practice had run a monthly search of all patients over 85 years who had not been seen within the past year and reviewed their records. If there had been no contact with any health care professional they attempted to contact the patient by telephone, if unsuccessful they sent a letter and if that failed a visit to the patient was made.

The areas where the provider should make improvement are:

• Ensure the process of managing uncollected prescriptions follows the practice protocol, as outlined in the repeat prescribing policy.
• Monitor the prescribing of individual prescribers.
• Review any significant events to identify any trends to prevent reoccurrence.
• Carry out regular infection control audits.
• Consider whether the practice needs additional oxygen for use in medical emergencies. In addition, have appropriate safety signage for the room where oxygen is stored; and add information as to where oxygen is stored to the fire map at the entrance of the practice for fire officer’s information.
• The practice should consider adding further advice to staff as to what to do in other types of emergency other than power /IT failure within the business contingency plan.
• Have a system to review dates for when safety checks such as electrical and for fire safety equipment are due.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 May 2017

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

• Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.
• 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.
• 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.
• Patients who were coded as ‘housebound’ did not receive recall letters, these patients were on a separate Long Term Chronic Disease Home Visit register which allowed the practice to arrange home visits with the practice nurse to carry out the reviews.
• 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 25 May 2017

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

• The practice worked with midwives’ and health visitors to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics and provided immunisations.
• The practice had emergency processes for acutely ill children and young people.
• The practice manger and chair of the PPG had attended a local school to gain the views of teenagers as to what medical services they required. Teenagers involved had helped produce a newsletter for the practice to highlight areas of importance to this population group.
• One of the GPs attended a primary school to give educational sessions regarding healthy lifestyles. 

Updated 25 May 2017

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

• 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.
• The practice had designed a leaflet intended for the over 75s with useful contact numbers.
• Over the past 12 months the practice had run a monthly search of all patients over 85 years who had not been seen within the past year and reviewed their records. If there had been no contact with any health care professional they attempted to contact the patient by telephone, if unsuccessful they sent a letter and if that failed a visit to the patient was made.

Updated 25 May 2017

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

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.
• The practice had additional Saturday morning clinics for flu vaccinations for patients who could not attend during the working week.

Updated 25 May 2017

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

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living 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
• Staff had received training about suicide awareness and dementia.

Updated 25 May 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.
• 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.